Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12799 | Date 19/03/2025 |
| Token No | SM/25-26/2351 21/10/2025 | Serial | 004 |
| Patient Name | Master MD SARIM | Contact No | 9123331886 |
| Address | 21 DR. N L B STREET | Age | 1 yr 6 months Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||