Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 12859 | Date 05/04/2025 |
| Token No | SM/25-26/50 05/04/2025 | Serial | 003 |
| Patient Name | Mrs. RINKU DEVI | Contact No | 8100506553 |
| Address | RAM SITA LANE | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||