Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13412 | Date 26/08/2025 |
| Token No | SM/25-26/1743 26/08/2025 | Serial | 010 |
| Patient Name | Mrs. BHARTI DEBI | Contact No | 9330713898 |
| Address | 122 R B SARANI | Age | 42 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||