Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11719 | Date 29/06/2024 |
| Token No | SM/25-26/2107 18/09/2025 | Serial | 030 |
| Patient Name | Miss RITIKA RAY | Contact No | 9065296617 |
| Address | 86 DEY STREET | Age | 5 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||