Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09834 | Date 28/08/2025 |
| Token No | SM/25-26/7070 28/08/2025 | Serial | 079 |
| Patient Name | Miss SWASTI KUMARI | Contact No | 8481960374 |
| Address | CHOTO BELU CHECK POST SERAMPORE 712203 | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||