Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13001 | Date 19/05/2025 |
| Token No | SM/25-26/1150 10/07/2025 | Serial | 014 |
| Patient Name | Mrs. SANDHYA GOMES | Contact No | 9903291058 |
| Address | 177 N N COLONY | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||