Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11239 | Date 06/03/2024 |
| Token No | SM/25-26/511 19/05/2025 | Serial | 024 |
| Patient Name | Mrs. USHA DEBI.. | Contact No | 9334519731 |
| Address | 1NO. GATE, KOLBAZAR | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||