Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07009 | Date 09/09/2022 |
| Token No | SM/25-26/1701 18/08/2025 | Serial | 001 |
| Patient Name | Mrs. SONA MATI DEVI | Contact No | NOT GIVEN |
| Address | 62 RAILAND ROAD | Age | 37 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||