Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13151 | Date 25/06/2025 |
| Token No | SM/25-26/1009 26/06/2025 | Serial | 029 |
| Patient Name | Mrs. SARDA KOIRI | Contact No | 7980070955 |
| Address | 79 DEY STREET | Age | 42 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||