Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12870 | Date 07/04/2025 |
| Token No | SM/25-26/90 07/04/2025 | Serial | 034 |
| Patient Name | Mrs. SANGITA DAS | Contact No | 9330534591 |
| Address | 1/D KL GOSWAMI SARANI | Age | 25 Y Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||