Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 14989 | Date 27/10/2026 |
| Token No | SM/25-26/6092 28/10/2026 | Serial | 012 |
| Patient Name | Miss DIPSIKHA DAS | Contact No | 9330783677 |
| Address | BAT TALA | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||