Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08064 | Date 29/12/2022 |
| Token No | SM/25-26/142 17/04/2025 | Serial | 003 |
| Patient Name | Mrs. MANASI PAL | Contact No | 9836083879 |
| Address | 3 KASHI DOCTOR LANE | Age | 49 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||