Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13271 | Date 23/07/2025 |
| Token No | SM/25-26/1377 24/07/2025 | Serial | 016 |
| Patient Name | Miss CHANDNI KUMARI | Contact No | 9123651490 |
| Address | 103 R.B. SARANI | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||