Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13331 | Date 31/07/2025 |
| Token No | SM/25-26/1502 31/07/2025 | Serial | 014 |
| Patient Name | Mrs. RUMA PAL | Contact No | 9874566507 |
| Address | 140/C NN COLONY | Age | 34 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||