Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 13795 | Date 28/11/2025 |
| Token No | SM/25-26/2823 01/12/2025 | Serial | 007 |
| Patient Name | Mrs. NUPUR DAS | Contact No | 7439749859 |
| Address | 223 G T ROAD | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||