Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12552 | Date 22/01/2025 |
| Token No | SM/25-26/1358 23/07/2025 | Serial | 031 |
| Patient Name | Mrs. GARGEE SAMANTA | Contact No | 7908371566 |
| Address | 112 THAKURBATI STREET | Age | 32 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||