Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13762 | Date 22/11/2025 |
| Token No | SM/25-26/2996 13/12/2025 | Serial | 012 |
| Patient Name | Mrs. KRITI SRIVASTAV | Contact No | 9681772547 |
| Address | 136 DEY BAGAN | Age | 38 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||