Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05362 | Date 28/01/2022 |
| Token No | SM/25-26/1438 28/07/2025 | Serial | 029 |
| Patient Name | Mrs. GITA BAIRAGI | Contact No | 9903268518 |
| Address | 46A POTUA PARA LANE | Age | 63 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||