Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13848 | Date 11/12/2025 |
| Token No | SM/25-26/2954 11/12/2025 | Serial | 002 |
| Patient Name | Mrs. SUMAN PRASAD | Contact No | 9903165453 |
| Address | JITEN LAHIRI ROAD | Age | 32 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||