Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13070 | Date 04/06/2025 |
| Token No | SM/25-26/664 05/06/2025 | Serial | 004 |
| Patient Name | Miss NEHA SHAW | Contact No | 9330873743 |
| Address | 55 RAYLAND ROAD | Age | 19 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||