Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13903 | Date 29/12/2025 |
| Token No | SM/25-26/3119 29/12/2025 | Serial | 025 |
| Patient Name | Mrs. KHUSHBU KUMARI | Contact No | 9334863171 |
| Address | 125 R.B. SARANI | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||