Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 13365 | Date 11/08/2025 |
| Token No | SM/25-26/1625 11/08/2025 | Serial | 018 |
| Patient Name | Mrs. SUNITA BISWAL | Contact No | 9439736859 |
| Address | 19 DOSTY LANE | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||