Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13149 | Date 25/06/2025 |
| Token No | SM/25-26/951 25/06/2025 | Serial | 005 |
| Patient Name | Mrs. RINKU DEBI | Contact No | 8368297716 |
| Address | RAM SITA LANE | Age | 29 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||