Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10528 | Date 26/09/2023 |
| Token No | SM/25-26/930 23/06/2025 | Serial | 002 |
| Patient Name | Miss BABITA SINGH | Contact No | 9748377653 |
| Address | 17 PAL BAGAN | Age | 16 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||