Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13657 | Date 25/10/2025 |
| Token No | SM/25-26/2420 29/10/2025 | Serial | 009 |
| Patient Name | Mrs. JAYANTI PAL | Contact No | 6289758482 |
| Address | KALITALA MAHESH | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||