Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10475 | Date 22/09/2023 |
| Token No | SM/25-26/2932 09/12/2025 | Serial | 005 |
| Patient Name | Baby DISHA PRADHAN | Contact No | 8017111768 |
| Address | ram sita lane | Age | 3 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||