Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08934 | Date 02/05/2023 |
| Token No | SM/25-26/802 12/06/2025 | Serial | 027 |
| Patient Name | Mr. CHANDAN PADIALI | Contact No | 8479051690 |
| Address | 19 DOSTI LANE | Age | 15 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||