Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13481 | Date 08/09/2025 |
| Token No | SM/25-26/1987 10/09/2025 | Serial | 014 |
| Patient Name | Mrs. KANCHAN KAR. | Contact No | 8017148062 |
| Address | 118 G T ROAD | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||