Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05131 | Date 02/12/2021 |
| Token No | SM/25-26/2439 30/10/2025 | Serial | 008 |
| Patient Name | Miss MARYAM ARA | Contact No | 9403019283 |
| Address | 10 CHATTERJEE LANE | Age | 6 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||