Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13005 | Date 19/05/2025 |
| Token No | SM/25-26/504 19/05/2025 | Serial | 017 |
| Patient Name | Mrs. JOLLY SRIMANI | Contact No | 9681620595 |
| Address | 62 A DEY STREET | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||