Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 09693 | Date 05/08/2025 |
| Token No | SM/25-26/5853 05/08/2025 | Serial | 019 |
| Patient Name | Mrs. GOURI MAKAL | Contact No | 8777481679 |
| Address | 21 NO JN LAHIRI ROAD 712201 | Age | 74 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||