Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13744 | Date 18/11/2025 |
| Token No | SM/25-26/2667 18/11/2025 | Serial | 006 |
| Patient Name | Baby SHRABANI MONDAL | Contact No | 7884092933 |
| Address | MAHESH, SOSTHITALA | Age | 4 yrs 3 months Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||