Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13377 | Date 13/08/2025 |
| Token No | SM/25-26/1668 13/08/2025 | Serial | 023 |
| Patient Name | Mrs. DEEPA KUMARI | Contact No | 7759924874 |
| Address | 11 INDIA JUTE MILL | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||