Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 07353 | Date 03/07/2024 |
| Token No | SM/25-26/10283 11/11/2025 | Serial | 014 |
| Patient Name | Miss RESHMI SHAW | Contact No | 9681052662 |
| Address | 319 S K NAGAR RISHRA 712249 | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||