Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12909 | Date 23/04/2025 |
| Token No | SM/25-26/249 24/04/2025 | Serial | 012 |
| Patient Name | Miss SANJU KUMARI | Contact No | 9163935051 |
| Address | 13 DEY GHAT LANE | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||