Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13506 | Date 11/09/2025 |
| Token No | SM/25-26/2015 12/09/2025 | Serial | 001 |
| Patient Name | Miss RIYA KUMARI | Contact No | 8420281846 |
| Address | 53 DEY STREET | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||