Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13333 | Date 05/08/2025 |
| Token No | SM/25-26/1553 06/08/2025 | Serial | 014 |
| Patient Name | Miss KARUNA TANTI | Contact No | 7980419933 |
| Address | 82 DEY STREET | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||