Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10193 | Date 20/11/2025 |
| Token No | SM/25-26/10757 21/11/2025 | Serial | 003 |
| Patient Name | Mrs. REKHA KUMARI | Contact No | 7003968261 |
| Address | 9/437/A GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 16 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||