Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13177 | Date 26/06/2025 |
| Token No | SM/25-26/1468 30/07/2025 | Serial | 008 |
| Patient Name | Mrs. SANDHYA SINGH | Contact No | 7003410772 |
| Address | 23 DR. N.L.B. STREET | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||