Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12651 | Date 13/02/2025 |
| Token No | SM/24-25/20939 13/02/2025 | Serial | 001 |
| Patient Name | Mrs. TOSALI DEY | Contact No | 7003220749 |
| Address | 9 NO PANDIT KALINATH | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||