Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12882 | Date 12/04/2025 |
| Token No | SM/25-26/139 12/04/2025 | Serial | 002 |
| Patient Name | Mrs. ANKITA TIWARI | Contact No | 6289025556 |
| Address | 76 DEY STREET | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||