Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13894 | Date 29/12/2025 |
| Token No | SM/25-26/3126 31/12/2025 | Serial | 006 |
| Patient Name | Mrs. USHA DEBI RAM | Contact No | 9681309742 |
| Address | 4 AKRABATI LANE | Age | 38 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||