Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13213 | Date 07/07/2025 |
| Token No | SM/25-26/1122 07/07/2025 | Serial | 026 |
| Patient Name | Mrs. LAXMI DEVI | Contact No | 8777874872 |
| Address | 34 BLC ROAD | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||