Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 10990 | Date 21/12/2023 |
| Token No | SM/25-26/153 17/04/2025 | Serial | 014 |
| Patient Name | Mrs. SARASWATI DAS. | Contact No | 9433136901 |
| Address | 47 DHULIPARA LANE | Age | 72 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||