Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13899 | Date 29/12/2025 |
| Token No | SM/25-26/3111 29/12/2025 | Serial | 017 |
| Patient Name | Mrs. SWAPNA DAS | Contact No | 7605829645 |
| Address | 49 NO BHAGIRATHI LANE | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||