Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13020 | Date 24/05/2025 |
| Token No | SM/25-26/547 24/05/2025 | Serial | 007 |
| Patient Name | Baby SRITAMA DAS | Contact No | 7980700433 |
| Address | 41 K D B LANE | Age | 3 YRS 5 mnths Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||