Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13621 | Date 15/10/2025 |
| Token No | SM/25-26/2301 15/10/2025 | Serial | 012 |
| Patient Name | Miss NANDINI KUMARI | Contact No | 7890923882 |
| Address | JOLKOL | Age | 10 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||