Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 14980 | Date 26/10/2026 |
| Token No | SM/25-26/6060 26/10/2026 | Serial | 010 |
| Patient Name | Baby ANAYA KOIRI | Contact No | 7044354794 |
| Address | 8 HOSPITAL LANE | Age | DOB: 21.07.26 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||