Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13714 | Date 08/11/2025 |
| Token No | SM/25-26/2547 08/11/2025 | Serial | 002 |
| Patient Name | Miss SONIA PARUI | Contact No | 9674970963 |
| Address | NALIKUL | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||