Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10108 | Date 23/08/2023 |
| Token No | SM/25-26/601 26/05/2025 | Serial | 009 |
| Patient Name | Miss SIDDHI KOIRI | Contact No | 7278869737 |
| Address | 79 DEY STREET | Age | 3 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||