Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13221 | Date 10/07/2025 |
| Token No | SM/25-26/1167 10/07/2025 | Serial | 031 |
| Patient Name | Mrs. KABITA SUBODH SHAH | Contact No | 9920406084 |
| Address | SERAMPORE | Age | 28 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||