Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13378 | Date 14/08/2025 |
| Token No | SM/25-26/1672 14/08/2025 | Serial | 004 |
| Patient Name | Miss SHRAYANKA MALIK | Contact No | 9749661052 |
| Address | 40A/3 BHAGIRATHI LANE | Age | 16 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||