Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13220 | Date 10/07/2025 |
| Token No | SM/25-26/1166 10/07/2025 | Serial | 030 |
| Patient Name | Mrs. MADHURIMA DAS | Contact No | 9830829542 |
| Address | R. B SARANI | Age | 34 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||