Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13653 | Date 25/10/2025 |
| Token No | SM/25-26/2383 25/10/2025 | Serial | 005 |
| Patient Name | Baby KRITI SHAW | Contact No | 6290014255 |
| Address | 55 RAILAND ROAD | Age | 8 months Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||