Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10144 | Date 06/11/2025 |
| Token No | SM/25-26/10114 08/11/2025 | Serial | 009 |
| Patient Name | Mrs. CHUMKY BAG | Contact No | 9830327369 |
| Address | JAGANNATHPUR RISHRA M BAMUNARI 712250 | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||