Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 09879 | Date 04/08/2023 |
| Token No | SM/25-26/1756 28/08/2025 | Serial | 004 |
| Patient Name | Miss BARSHA RAJBHAR | Contact No | 9831165762 |
| Address | 27 BAZAR BYE LANE, TIN BAZAR | Age | 16 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||