Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13617 | Date 15/10/2025 |
| Token No | SM/25-26/2293 15/10/2025 | Serial | 004 |
| Patient Name | Mrs. KANCHAN KUMARI | Contact No | 9082609116 |
| Address | 38 RAILWAY QUARTER | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||