Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13042 | Date 24/05/2025 |
| Token No | SM/25-26/575 24/05/2025 | Serial | 035 |
| Patient Name | Miss ADRITI KOIRI | Contact No | 7890401311 |
| Address | 79 DEY STREET | Age | 4 YRS 6 MONTHS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||