Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13623 | Date 15/10/2025 |
| Token No | SM/25-26/2325 16/10/2025 | Serial | 017 |
| Patient Name | Mrs. CHHABI DAS | Contact No | 9007948927 |
| Address | 67 N.N. COLONY | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||