Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13603 | Date 11/10/2025 |
| Token No | SM/25-26/2295 15/10/2025 | Serial | 006 |
| Patient Name | Mrs. RESHMI KUMARI SINGH | Contact No | 8910011350 |
| Address | 122/A R.B SARANI | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||