Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13106 | Date 12/06/2025 |
| Token No | SM/25-26/795 12/06/2025 | Serial | 020 |
| Patient Name | Mrs. KAVITA SINGH | Contact No | 9007785147 |
| Address | 14 RAM SITA LANE | Age | 34 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||