Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12118 | Date 20/09/2024 |
| Token No | SM/25-26/432 12/05/2025 | Serial | 010 |
| Patient Name | Mrs. ANJALI KUMARI | Contact No | 8585893628 |
| Address | 82 NO DEY STREET | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||