Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12975 | Date 09/05/2025 |
| Token No | SM/25-26/1659 13/08/2025 | Serial | 014 |
| Patient Name | Mrs. NILU KUMARI CHOUHAN | Contact No | 9330759685 |
| Address | RAM SITA LANE | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||