Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09099 | Date 11/04/2025 |
| Token No | SM/25-26/639 12/04/2025 | Serial | 004 |
| Patient Name | Mrs. SARMAILA ADHIKARY | Contact No | |
| Address | GHORAMARA PURBAPARA MALLICKPARA 712203 | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||