Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12256 | Date 21/10/2024 |
| Token No | SM/25-26/2938 09/12/2025 | Serial | 011 |
| Patient Name | Mrs. SUCHINTA DEBI | Contact No | 9330159493 |
| Address | RAMSITA LANE | Age | 40YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||