Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13494 | Date 09/09/2025 |
| Token No | SM/25-26/1962 09/09/2025 | Serial | 005 |
| Patient Name | Miss SUSHMA BHUIYA | Contact No | 8777459801 |
| Address | J N LAHIRI ROAD | Age | 14 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||