Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12963 | Date 05/05/2025 |
| Token No | SM/25-26/374 05/05/2025 | Serial | 033 |
| Patient Name | Mrs. PRITI KUMARI BISWAL | Contact No | 7008123932 |
| Address | 43 PANCHANAN TALA LANE | Age | 27 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||