Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13788 | Date 27/11/2025 |
| Token No | SM/25-26/2796 27/11/2025 | Serial | 012 |
| Patient Name | Master UTKARSH GORU | Contact No | 8910020037 |
| Address | 5/C B L CMILLS ROAD | Age | 3 years 8 month Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||