Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13827 | Date 05/12/2025 |
| Token No | SM/25-26/2918 08/12/2025 | Serial | 013 |
| Patient Name | Mrs. PUTUL SHIL | Contact No | 7980165331 |
| Address | 127 N N COLONY | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||