Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13224 | Date 11/07/2025 |
| Token No | SM/25-26/1215 14/07/2025 | Serial | 019 |
| Patient Name | Mr. HIRALAL SASMAL | Contact No | 8420589785 |
| Address | 40/A BHAGIRATHI LANE | Age | 45 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||