Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01786 | Date 15/03/2019 |
| Token No | SM/25-26/2914 08/12/2025 | Serial | 009 |
| Patient Name | Mr. NARESH PRASAD | Contact No | 8777892160 |
| Address | 52 DEY STREET | Age | 52 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||