Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13036 | Date 24/05/2025 |
| Token No | SM/25-26/568 24/05/2025 | Serial | 028 |
| Patient Name | Miss TRISHA SHAW | Contact No | 9088266797 |
| Address | SINGHA GOLI | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||