Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05363 | Date 31/01/2022 |
| Token No | SM/25-26/2004 10/09/2025 | Serial | 031 |
| Patient Name | Mrs. SHIPRA KUMAR | Contact No | 9051295270 |
| Address | BSNL OFFICE WORKER | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||