Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 09531 | Date 04/07/2023 |
| Token No | SM/25-26/2063 15/09/2025 | Serial | 020 |
| Patient Name | Mrs. MINU SIL | Contact No | 7450047046 |
| Address | N N COLONY | Age | 62 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||