Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08292 | Date 08/02/2023 |
| Token No | SM/25-26/2950 10/12/2025 | Serial | 012 |
| Patient Name | Mrs. RUBY DAS | Contact No | 8335901696 |
| Address | 20 R B SARANI | Age | 66 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||