Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 12644 | Date 10/02/2025 |
| Token No | SM/25-26/456 15/05/2025 | Serial | 007 |
| Patient Name | Mrs. MAMTA DEVI | Contact No | 8910465648 |
| Address | 126 RISHI BANKIM SARANI | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||