Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13838 | Date 08/12/2025 |
| Token No | SM/25-26/2908 08/12/2025 | Serial | 003 |
| Patient Name | Mrs. DOLLY MONDAL PAUL | Contact No | 9547166147 |
| Address | 42 GT ROAD | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||