Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 10768 | Date 09/11/2023 |
| Token No | SM/25-26/423 12/05/2025 | Serial | 001 |
| Patient Name | Mrs. ANURADHA MODOK | Contact No | 8250379447 |
| Address | JOLKOL OFFICE | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||