Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12600 | Date 30/01/2025 |
| Token No | SM/25-26/2913 08/12/2025 | Serial | 008 |
| Patient Name | Mrs. PUNAM DEBI | Contact No | 8100317529 |
| Address | RAMSITA LANE, NAYA BAGAN | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||