Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13389 | Date 14/08/2025 |
| Token No | SM/25-26/1691 14/08/2025 | Serial | 023 |
| Patient Name | Mrs. PUNAM PRASAD | Contact No | 7003583046 |
| Address | 12 R B SARANI | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||