Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12457 | Date 14/12/2024 |
| Token No | SM/25-26/1887 03/09/2025 | Serial | 022 |
| Patient Name | Miss PAYEL TANTI | Contact No | 7439163142 |
| Address | 13 DOSTI LANE | Age | 19 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||