Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13832 | Date 06/12/2025 |
| Token No | SM/25-26/2915 08/12/2025 | Serial | 010 |
| Patient Name | Miss SUPRIYA BISWAL | Contact No | 9668608755 |
| Address | 55 DR. N L B STREET | Age | 19 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||