Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04508 | Date 14/07/2023 |
| Token No | SM/24-25/35232 06/02/2025 | Serial | 041 |
| Patient Name | Mrs. NANDINI DUBEY | Contact No | 8240495965 |
| Address | 9/A/1/190 M J ROAD PROVASHNAGAR SERAMPRE 712249 | Age | 15 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||