Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13507 | Date 11/09/2025 |
| Token No | SM/25-26/2013 11/09/2025 | Serial | 008 |
| Patient Name | Mr. PREM GOND | Contact No | 7439456171 |
| Address | PACHUBAZAR | Age | 23 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||