Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13561 | Date 22/09/2025 |
| Token No | SM/25-26/2158 22/09/2025 | Serial | 013 |
| Patient Name | Mrs. ESTHER LALRUATFELI | Contact No | 7629977832 |
| Address | WILLIAM CAREY ROAD | Age | 33 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||