Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13054 | Date 26/05/2025 |
| Token No | SM/25-26/598 26/05/2025 | Serial | 006 |
| Patient Name | Baby SHIBANI DAS | Contact No | 9674618353 |
| Address | KALITALA KATAPOL | Age | 6 MONTHS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||