Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12887 | Date 17/04/2025 |
| Token No | SM/25-26/152 17/04/2025 | Serial | 013 |
| Patient Name | Miss UTSHA NANDI | Contact No | 8444049653 |
| Address | 5/A LMB STREET | Age | 15 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||