Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 09768 | Date 25/07/2023 |
| Token No | SM/25-26/1482 30/07/2025 | Serial | 022 |
| Patient Name | Mrs. RITA DEBI | Contact No | 8478921416 |
| Address | 104 R B SARANI | Age | 37 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||