Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 13444 | Date 01/09/2025 |
| Token No | SM/25-26/1841 01/09/2025 | Serial | 041 |
| Patient Name | Mrs. NIPPU DAS | Contact No | 8240101494 |
| Address | 70 BLC MILL ROAD | Age | 30 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||