Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08874 | Date 26/04/2023 |
| Token No | SM/25-26/2690 20/11/2025 | Serial | 004 |
| Patient Name | Mrs. MANISHA NATH | Contact No | 8100098150 |
| Address | 8 DOSTI LANE | Age | 26 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||