Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13547 | Date 19/09/2025 |
| Token No | SM/25-26/2122 19/09/2025 | Serial | 011 |
| Patient Name | Miss PRIYANKA MALBIYA | Contact No | 7495886034 |
| Address | 11/A S.B. GHOSH LANE | Age | 8 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||