Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09443 | Date 12/06/2025 |
| Token No | SM/25-26/3437 12/06/2025 | Serial | 055 |
| Patient Name | Miss ANUSHKA SHARMA | Contact No | 9883112402 |
| Address | DAKSHIN KUMRAKHALI PURBAPARA RAJPUR S 24 PRGS 700103 | Age | 14 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||