Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 11177 | Date 21/02/2024 |
| Token No | SM/24-25/20367 23/12/2024 | Serial | 035 |
| Patient Name | Mrs. SUMITRA DEBI | Contact No | 7890060545 |
| Address | 104 JAILKHANA LANE | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||