Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13670 | Date 29/10/2025 |
| Token No | SM/25-26/2429 29/10/2025 | Serial | 018 |
| Patient Name | Mrs. BINDU DEVI | Contact No | 7044377042 |
| Address | 55 RAY LAND ROAD | Age | 48 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||