Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04976 | Date 28/08/2023 |
| Token No | SM/25-26/3397 12/06/2025 | Serial | 015 |
| Patient Name | Mrs. SABITA DEBI | Contact No | 8100637850 |
| Address | 524 S K NAGAR RISHRA M 712249 | Age | 38 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||