Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11052 | Date 18/01/2024 |
| Token No | SM/25-26/264 26/04/2025 | Serial | 003 |
| Patient Name | Mrs. MINATI DAS | Contact No | NOT GIVEN |
| Address | NALIKUL | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||