Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11477 | Date 06/05/2024 |
| Token No | SM/25-26/1312 21/07/2025 | Serial | 021 |
| Patient Name | Miss SHRUTI METE | Contact No | 9748382546 |
| Address | 11A A.B. GARDEN LANE | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||