Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06294 | Date 17/02/2024 |
| Token No | SM/25-26/5846 05/08/2025 | Serial | 012 |
| Patient Name | Mrs. ANITA SHAW | Contact No | 8272917520 |
| Address | GHORAMARA PURBAPARA SERAMPOE 712203 | Age | 54 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | 140/80 mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||