Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13219 | Date 10/07/2025 |
| Token No | SM/25-26/2263 11/10/2025 | Serial | 018 |
| Patient Name | Mrs. BHASWATI LAHIRII | Contact No | 6290316223 |
| Address | 22 NO KC LANE | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||