Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13160 | Date 25/06/2025 |
| Token No | SM/25-26/974 25/06/2025 | Serial | 028 |
| Patient Name | Mrs. DURGA SHARMA | Contact No | 8622023084 |
| Address | 10 NO RAIL QUATER | Age | 48 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||