Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13641 | Date 21/10/2025 |
| Token No | SM/25-26/2416 29/10/2025 | Serial | 005 |
| Patient Name | Mrs. TUMPA DAS | Contact No | 9330260397 |
| Address | 118 G.T. ROAD, MANIKTALA | Age | 53 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||