Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13076 | Date 05/06/2025 |
| Token No | SM/25-26/810 12/06/2025 | Serial | 035 |
| Patient Name | Mrs. PIYALI DOLUI | Contact No | 9874061694 |
| Address | 25 PANDIT KALINATH B. STREET | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||