Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09837 | Date 02/08/2023 |
| Token No | SM/25-26/2620 13/11/2025 | Serial | 022 |
| Patient Name | Miss NISHA KUMARI | Contact No | 7439021685 |
| Address | RAM SITA LANE | Age | 7 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||