Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12677 | Date 17/02/2025 |
| Token No | SM/25-26/1603 08/08/2025 | Serial | 012 |
| Patient Name | Mrs. SHILPI KUMARI SHAW | Contact No | 9748066917 |
| Address | 10 NO RAM SITA LANE | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||