Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12910 | Date 23/04/2025 |
| Token No | SM/25-26/626 02/06/2025 | Serial | 002 |
| Patient Name | Mrs. LALITA DEBI | Contact No | 8651065632 |
| Address | 43 BHAGIRATHI LANE | Age | 42 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||