Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06145 | Date 18/06/2022 |
| Token No | SM/25-26/2517 05/11/2025 | Serial | 003 |
| Patient Name | Mrs. NISHA JAISWAL | Contact No | 9007057008 |
| Address | 35/1 POTUA PARA | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||