Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13421 | Date 28/08/2025 |
| Token No | SM/25-26/1921 06/09/2025 | Serial | 009 |
| Patient Name | Mrs. JYOTI KUMARI PRASAD | Contact No | 7980183878 |
| Address | 85 RB SARANI | Age | 30 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||