Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 09764 | Date 16/08/2025 |
| Token No | SM/25-26/6447 16/08/2025 | Serial | 015 |
| Patient Name | Miss NISHA KUMARI | Contact No | 8100689235 |
| Address | 66/C/2 PRAVASHNAGAR RISHRA M 712249 | Age | 17 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||