Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 10180 | Date 15/11/2025 |
| Token No | SM/25-26/10614 18/11/2025 | Serial | 013 |
| Patient Name | Mrs. BIMALA DEVI SHAW | Contact No | 9681052662 |
| Address | 319 S K NAGAR PRAVASHNAGAR RISHRA M 712249 | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||