Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13660 | Date 25/10/2025 |
| Token No | SM/25-26/2396 25/10/2025 | Serial | 018 |
| Patient Name | Miss KOMAL PARIDA | Contact No | 8100568025 |
| Address | CHATTERJEE LANE | Age | 4 MONTHS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||