Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13667 | Date 28/10/2025 |
| Token No | SM/25-26/2411 28/10/2025 | Serial | 008 |
| Patient Name | Miss RUPALI MALBIYA | Contact No | 8382961948 |
| Address | 11/N S.B. GHOSH LANE | Age | 7 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||