Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13069 | Date 04/06/2025 |
| Token No | SM/25-26/663 05/06/2025 | Serial | 003 |
| Patient Name | Miss SUMAN SHAW | Contact No | 9330783031 |
| Address | 55 RAYLAND ROAD | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||