Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10810 | Date 23/11/2023 |
| Token No | SM/25-26/415 08/05/2025 | Serial | 006 |
| Patient Name | Mrs. UMRAWATI GUPTA | Contact No | 8423197161 |
| Address | 79 DEY STREET | Age | 62 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||