Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12822 | Date 24/03/2025 |
| Token No | SM/24-25/21444 24/03/2025 | Serial | 003 |
| Patient Name | Mrs. TUMPA SAMANTA | Contact No | 6290211858 |
| Address | 7 NO SASHIBHUSAN GHOSH LANE | Age | 27 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||