Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10396 | Date 14/09/2023 |
| Token No | SM/25-26/2366 22/10/2025 | Serial | 007 |
| Patient Name | Mrs. RABITA DEBI | Contact No | 8910841044 |
| Address | 84 DEY STREET | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||