Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12496 | Date 24/12/2024 |
| Token No | SM/24-25/20381 26/12/2024 | Serial | 003 |
| Patient Name | Mrs. KANCHAN DAS | Contact No | 9110147967 |
| Address | 55 NO ROYLAND ROAD | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||