Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 12898 | Date 21/04/2025 |
| Token No | SM/25-26/177 21/04/2025 | Serial | 022 |
| Patient Name | Mr. LALLAN PARBAT | Contact No | 8585020021 |
| Address | 18 JHAUTALA | Age | 69 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||