Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13534 | Date 18/09/2025 |
| Token No | SM/25-26/2094 18/09/2025 | Serial | 017 |
| Patient Name | Miss NISHA TANTI | Contact No | 9088172507 |
| Address | 13 DOSTI LANE | Age | 24 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||