Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11515 | Date 13/05/2024 |
| Token No | SM/25-26/2544 07/11/2025 | Serial | 004 |
| Patient Name | Mrs. BELI RAJBHAR | Contact No | 8902525338 |
| Address | 3 PITAMBAR DEY LANE | Age | 74 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||