Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09053 | Date 05/04/2025 |
| Token No | SM/25-26/8737 07/10/2025 | Serial | 033 |
| Patient Name | Miss ARUSHI RAM | Contact No | 9007716652 |
| Address | GHORAMARA SERAMPORE 712203 | Age | 9 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||