Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10223 | Date 27/11/2025 |
| Token No | SM/25-26/11063 27/11/2025 | Serial | 016 |
| Patient Name | Mrs. SONAM DEY | Contact No | 7890869532 |
| Address | GHORAMARA MALLICKPARA 712203 | Age | 32 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||