Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13724 | Date 12/11/2025 |
| Token No | SM/25-26/2588 12/11/2025 | Serial | 015 |
| Patient Name | Mrs. KOMAL DEVI | Contact No | 9250674699 |
| Address | PACHU BAZAR | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||