Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13839 | Date 08/12/2025 |
| Token No | SM/25-26/2939 10/12/2025 | Serial | 001 |
| Patient Name | Mr. SRIKANT GOND | Contact No | |
| Address | RAIL QUATER | Age | 55 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||