Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 15845 | Date 05/08/2025 |
| Token No | SM/25-26/4567 06/08/2025 | Serial | 012 Last Visit: 11/08/2025 |
| Patient Name | Miss SONALI DAS | Contact No | 9062123988 |
| Address | CHOTO BELU BELUMILKI | Age | 18 Years,5 Months,12 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 33.6 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||