Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11430 | Date 22/04/2024 |
| Token No | SM/25-26/2393 25/10/2025 | Serial | 015 |
| Patient Name | Mrs. PUJA KUMARI | Contact No | 9801462650 |
| Address | 15 RAM SITA LANE | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||