Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 08877 | Date 26/04/2023 |
| Token No | SM/25-26/1178 11/07/2025 | Serial | 011 |
| Patient Name | Miss PAYEL GUPTA | Contact No | 8100158102 |
| Address | N N COLONY | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||