Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13605 | Date 13/10/2025 |
| Token No | SM/25-26/2314 16/10/2025 | Serial | 006 |
| Patient Name | Mrs. RATNA PRADHAN | Contact No | |
| Address | 9 NO INDIA JUTE MILL | Age | 70 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||