Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07053 | Date 15/09/2022 |
| Token No | SM/25-26/577 24/05/2025 | Serial | 037 |
| Patient Name | Baby SANVI KOIRI | Contact No | 7278869737 |
| Address | 79 DEY ST | Age | 4 YRS 3 MONTHS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||