Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13483 | Date 08/09/2025 |
| Token No | SM/25-26/1932 08/09/2025 | Serial | 004 |
| Patient Name | Miss RIYA SHAW | Contact No | 9330099173 |
| Address | INDIA JUTE MILL | Age | 9 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||