Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13249 | Date 18/07/2025 |
| Token No | SM/25-26/1291 19/07/2025 | Serial | 010 |
| Patient Name | Mrs. CHAMPA GHOSH | Contact No | 9830602308 |
| Address | 34 J.N. LAHIRI ROAD | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||