Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 10193 | Date 29/08/2023 |
| Token No | SM/24-25/20909 10/02/2025 | Serial | 022 |
| Patient Name | Mrs. JYOTSNA PAL | Contact No | 8100316630 |
| Address | 34 J N L ROAD | Age | 22 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||