Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 10567 | Date 28/09/2023 |
| Token No | SM/25-26/2243 10/10/2025 | Serial | 011 |
| Patient Name | Miss NANDINI KUMARI | Contact No | 8777511709 |
| Address | 126 R B SARANI | Age | 17 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||