Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 11176 | Date 21/02/2024 |
| Token No | SM/25-26/208 23/04/2025 | Serial | 019 |
| Patient Name | Miss SIBANI KUMARI | Contact No | 7890060545 |
| Address | 104 JAILKHANA LANE | Age | 3 YRS 6 MONTHS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||