Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 14808 | Date 27/08/2026 |
| Token No | SM/25-26/5597 27/08/2026 | Serial | 003 |
| Patient Name | Master ANKUSH SAH | Contact No | 9771261442 |
| Address | 6 RAM SITA LANE | Age | DOB: 28.11.24 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||