Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13394 | Date 14/08/2025 |
| Token No | SM/25-26/1699 14/08/2025 | Serial | 031 |
| Patient Name | Mrs. DEEPA KUMARI | Contact No | |
| Address | 11 INDIA JUTE MILL | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||