Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07827 | Date 28/11/2022 |
| Token No | SM/25-26/155 19/04/2025 | Serial | 001 |
| Patient Name | Miss SADVI KOIRI | Contact No | 7549814490 |
| Address | 79 DEY STREET | Age | 6 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||