Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13185 | Date 30/06/2025 |
| Token No | SM/25-26/2566 10/11/2025 | Serial | 018 |
| Patient Name | Mrs. NEHA PRAJAPATI | Contact No | 6289529755 |
| Address | 55 ROYLAND ROAD | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||