Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 14991 | Date 28/10/2026 |
| Token No | SM/25-26/6093 28/10/2026 | Serial | 013 |
| Patient Name | Baby SHIBANI KUMARI | Contact No | 7278220735 |
| Address | 8 NO RAM SITA LANE | Age | 3 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||