Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 09145 | Date 22/05/2023 |
| Token No | SM/22-23/9745 22/05/2023 | Serial | 023 |
| Patient Name | Mrs. CHANDANI KUMARI | Contact No | 9903039997 |
| Address | 63 DHULI PARA LANE | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||