Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13388 | Date 14/08/2025 |
| Token No | SM/25-26/1689 14/08/2025 | Serial | 021 |
| Patient Name | Mrs. KIRAN DEBI | Contact No | 8478967423 |
| Address | 10/218 RAM SITA LANE | Age | 27 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||