Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13572 | Date 08/10/2025 |
| Token No | SM/25-26/2228 09/10/2025 | Serial | 029 |
| Patient Name | Mrs. DULIA DEVI | Contact No | 9432982164 |
| Address | 12 PITAMBAR DEY LANE | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||