Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13128 | Date 17/06/2025 |
| Token No | SM/25-26/864 17/06/2025 | Serial | 002 |
| Patient Name | Mrs. JYOTI BHARTI | Contact No | 8777563755 |
| Address | 14 J.N. LAHIRI ROAD (BIHAR) | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||