Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13847 | Date 09/12/2025 |
| Token No | SM/25-26/2941 10/12/2025 | Serial | 003 |
| Patient Name | Mrs. MADHUMATI PRADHAN | Contact No | 8017111736 |
| Address | RAM SITA LANE | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||