Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 14811 | Date 27/08/2026 |
| Token No | SM/25-26/5606 27/08/2026 | Serial | 012 |
| Patient Name | Master HARSH GUPTA | Contact No | 6290267702 |
| Address | 31/B DR NLB STREET | Age | DOB 26.10.2025 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||