Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13212 | Date 07/07/2025 |
| Token No | SM/25-26/2819 01/12/2025 | Serial | 003 |
| Patient Name | Mrs. SANDHYA KUMARI | Contact No | 8637396828 |
| Address | RAM SITA LANE | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||