Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13430 | Date 30/08/2025 |
| Token No | SM/25-26/1796 30/08/2025 | Serial | 004 |
| Patient Name | Mrs. NIKEE SINGH | Contact No | 7439589020 |
| Address | 54 PATUA PARA | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||