Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13313 | Date 28/07/2025 |
| Token No | SM/25-26/1444 28/07/2025 | Serial | 035 |
| Patient Name | Mrs. PUJA DEVI | Contact No | 9875369124 |
| Address | 124 | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||