Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13053 | Date 26/05/2025 |
| Token No | SM/25-26/620 27/05/2025 | Serial | 002 |
| Patient Name | Mrs. KHUSHI KUMARI | Contact No | 9708008768 |
| Address | 6 NO RAM SITA LANE | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||