Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13482 | Date 08/09/2025 |
| Token No | SM/25-26/1998 10/09/2025 | Serial | 025 |
| Patient Name | Mrs. BHARATI DAS | Contact No | |
| Address | PANCHANANTALA | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||