Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13231 | Date 15/07/2025 |
| Token No | SM/25-26/1249 16/07/2025 | Serial | 019 |
| Patient Name | Mr. MANISH PRASAD | Contact No | 9007152990 |
| Address | 3 DEY GHAT LANE | Age | 16 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||