Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12857 | Date 05/04/2025 |
| Token No | SM/25-26/79 07/04/2025 | Serial | 023 |
| Patient Name | Mr. MUKESH RAY | Contact No | 8420383364 |
| Address | RAM SITA LANE | Age | 35 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||