Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13514 | Date 12/09/2025 |
| Token No | SM/25-26/2030 12/09/2025 | Serial | 016 |
| Patient Name | Miss SONAM RAM | Contact No | 8582907296 |
| Address | 7 DEY GHAT LANE | Age | 11 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||