Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13391 | Date 14/08/2025 |
| Token No | SM/25-26/2503 03/11/2025 | Serial | 039 |
| Patient Name | Mrs. PUNAM DEBI | Contact No | 8777687053 |
| Address | 55 NO RAILAND ROAD | Age | 22 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||