Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13268 | Date 22/07/2025 |
| Token No | SM/25-26/1353 23/07/2025 | Serial | 026 |
| Patient Name | Miss SAKSHI KUMARI | Contact No | 8102875606 |
| Address | RAM SITA LANE | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||