Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01894 | Date 08/04/2019 |
| Token No | SM/25-26/2087 18/09/2025 | Serial | 010 |
| Patient Name | Mrs. CHHABI BAG | Contact No | 8902650222 |
| Address | 4 A B GARDEN LANE | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||