Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04745 | Date 17/08/2021 |
| Token No | SM/25-26/1484 30/07/2025 | Serial | 024 |
| Patient Name | Mr. BANAMALI BARAT | Contact No | NOT GIVEN |
| Address | 9 NO LINE | Age | 72 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||