Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13324 | Date 30/07/2025 |
| Token No | SM/25-26/1471 30/07/2025 | Serial | 011 |
| Patient Name | Mrs. ANJALI PANDEY | Contact No | 9830819397 |
| Address | 28/B THAKURBATI STREET | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||