Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03307 | Date 31/10/2019 |
| Token No | SM/25-26/1671 14/08/2025 | Serial | 003 |
| Patient Name | Mr. KALAWATI DEBI | Contact No | 9883966816 |
| Address | NAYA BAGAN | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||