Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13390 | Date 14/08/2025 |
| Token No | SM/25-26/1692 14/08/2025 | Serial | 024 |
| Patient Name | Mrs. SHIWANI KUMARI | Contact No | 8240559718 |
| Address | 82/22 PATUAPARA LANE | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||