Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12907 | Date 23/04/2025 |
| Token No | SM/25-26/254 24/04/2025 | Serial | 017 |
| Patient Name | Miss ANNU KUMARI | Contact No | 9330159493 |
| Address | RAM SITA LANE | Age | 17 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||