Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13850 | Date 11/12/2025 |
| Token No | SM/25-26/2958 11/12/2025 | Serial | 006 |
| Patient Name | Baby MAYURAKHHI SIL | Contact No | 9836304972 |
| Address | KASHI DOCTOR LANE | Age | 2 YEARS 8MONTHS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||