Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13699 | Date 04/11/2025 |
| Token No | SM/25-26/2962 11/12/2025 | Serial | 010 |
| Patient Name | Mrs. TUMPA DHAR | Contact No | 8420703925 |
| Address | 85 NEHERU NAGAR COLONY | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||