Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 13773 | Date 24/11/2025 |
| Token No | SM/25-26/2741 24/11/2025 | Serial | 028 |
| Patient Name | Miss AMRITA RAJBHAR | Contact No | 9883570680 |
| Address | TIN BAZAR | Age | 13 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||