Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13422 | Date 28/08/2025 |
| Token No | SM/25-26/2618 13/11/2025 | Serial | 020 |
| Patient Name | Mrs. SHILPI KUMARI SHAW | Contact No | 9330277541 |
| Address | 10 NO RUDRARAM PANDIT LANE | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||