Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13735 | Date 14/11/2025 |
| Token No | SM/25-26/2633 14/11/2025 | Serial | 010 |
| Patient Name | Miss KAVYA SHAW | Contact No | 9123044241 |
| Address | 39 DEY STREET | Age | 9 MONTHS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||