Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10100 | Date 28/10/2025 |
| Token No | SM/25-26/9589 28/10/2025 | Serial | 006 |
| Patient Name | Mrs. SARASWATI DAS | Contact No | 9836859682 |
| Address | 1 NO GOYALA PARA LANE 712201 | Age | 34 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||