Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12282 | Date 30/10/2024 |
| Token No | SM/24-25/19510 30/10/2024 | Serial | 003 |
| Patient Name | Mrs. RUPAM DEVI | Contact No | 8264736357 |
| Address | 3 G.T. ROAD | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||