Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05492 | Date 07/03/2022 |
| Token No | SM/25-26/2890 05/12/2025 | Serial | 004 |
| Patient Name | Mrs. LACHHMI BISWAL | Contact No | 9088659303 |
| Address | 10 DOSTI LANE | Age | 67 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||