Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13716 | Date 10/11/2025 |
| Token No | SM/25-26/2557 10/11/2025 | Serial | 009 |
| Patient Name | Mrs. KAJAL KUMARI | Contact No | 8100299149 |
| Address | 32 DR.N.L.B. STREET | Age | 23 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||