Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13775 | Date 24/11/2025 |
| Token No | SM/25-26/2775 26/11/2025 | Serial | 015 |
| Patient Name | Miss ANJALI SAH | Contact No | 8478956795 |
| Address | 6 RAM SITA LANE | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||