Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13718 | Date 11/11/2025 |
| Token No | SM/25-26/2569 11/11/2025 | Serial | 001 |
| Patient Name | Baby DIBYA BHARTI | Contact No | 6296389010 |
| Address | 17C N L B STREET | Age | 2 MONTHS 21 DAY Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||