Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12818 | Date 20/03/2025 |
| Token No | SM/24-25/21445 24/03/2025 | Serial | 004 |
| Patient Name | Mrs. UMA DEY | Contact No | 8145789181 |
| Address | 14/A/1 S.B. GHOSH LANE | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||