Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13470 | Date 04/09/2025 |
| Token No | SM/25-26/1896 04/09/2025 | Serial | 006 |
| Patient Name | Miss KAUSIKI DEY | Contact No | 8334884774 |
| Address | 41 NEHERU NAGAR COLONY | Age | 11 yr 5 months Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||