Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05631 | Date 09/11/2023 |
| Token No | SM/25-26/8186 19/09/2025 | Serial | 007 |
| Patient Name | Mrs. PINKI SINGH | Contact No | 8017555686 |
| Address | 8 SIMLA SATGHARA ROAD PRABASHNAGAR RISHRA M 712249 | Age | 34 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||