Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12542 | Date 16/01/2025 |
| Token No | SM/24-25/20549 16/01/2025 | Serial | 026 |
| Patient Name | Mrs. MOU DAS | Contact No | 9432804180 |
| Address | 72/D PATUAPARA LANE | Age | 34 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||