Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10315 | Date 19/12/2025 |
| Token No | SM/25-26/12140 19/12/2025 | Serial | 004 |
| Patient Name | Mrs. RESHMA BEGUM | Contact No | 9062843264 |
| Address | 88/A MIYAJAN DARJEE LANE MALLIKPARA 712203 | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||