Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13440 | Date 01/09/2025 |
| Token No | SM/25-26/1825 01/09/2025 | Serial | 025 |
| Patient Name | Mrs. TUMPA SHAW | Contact No | 9091632191 |
| Address | 36 PANDIT KALINATH B STREET | Age | 32 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||