Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12497 | Date 24/12/2024 |
| Token No | SM/25-26/141 17/04/2025 | Serial | 002 |
| Patient Name | Mrs. ANNAPURNA DAS | Contact No | 9163203578 |
| Address | 7/C T B STREET | Age | 57 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||