Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13761 | Date 22/11/2025 |
| Token No | SM/25-26/2703 22/11/2025 | Serial | 001 |
| Patient Name | Mrs. KHUSHBU KUMARI | Contact No | 8851615320 |
| Address | 125 R.B. SARANI | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||