Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 14992 | Date 28/10/2026 |
| Token No | SM/25-26/6095 28/10/2026 | Serial | 015 |
| Patient Name | Mrs. LILAWATI DEBI | Contact No | 7439389376 |
| Address | RAM SITA LANE | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||