Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 13386 | Date 14/08/2025 |
| Token No | SM/25-26/1700 16/08/2025 | Serial | 001 |
| Patient Name | Master RISHI SHA | Contact No | 7450043907 |
| Address | LBS ROAD | Age | 9 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||