Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12811 | Date 19/03/2025 |
| Token No | SM/24-25/21400 19/03/2025 | Serial | 038 |
| Patient Name | Mrs. JYOTI GUPTA | Contact No | 6290267702 |
| Address | 31/B DR. N.L.B STREET | Age | 22 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||