Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 11313 | Date 27/03/2024 |
| Token No | SM/24-25/18629 05/09/2024 | Serial | 021 |
| Patient Name | Mrs. KAKALI DEY | Contact No | 8017572246 |
| Address | 42 MADAM BAGAN | Age | 46 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||