Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 12926 | Date 24/04/2025 |
| Token No | SM/25-26/251 24/04/2025 | Serial | 014 |
| Patient Name | Mrs. GURIA KUMARI SHAW | Contact No | 8276852949 |
| Address | 19 NO BLC MILL ROAD | Age | 37 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||