Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13539 | Date 18/09/2025 |
| Token No | SM/25-26/2109 18/09/2025 | Serial | 032 |
| Patient Name | Miss CHHOTI KUMARI | Contact No | 9674489894 |
| Address | 5E GOPAL GANGULY LANE | Age | 17 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||