Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06637 | Date 25/04/2024 |
| Token No | SM/24-25/37039 18/03/2025 | Serial | 011 |
| Patient Name | Miss JANHABI SEN | Contact No | 9002858923 |
| Address | BHUSHAN POWER STILL | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||