Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 10211 | Date 29/08/2023 |
| Token No | SM/25-26/2552 10/11/2025 | Serial | 004 |
| Patient Name | Mr. LAKHSHMAN NATH THAKUR | Contact No | |
| Address | DEY STREET | Age | 57 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||