Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12883 | Date 17/04/2025 |
| Token No | SM/25-26/143 17/04/2025 | Serial | 004 |
| Patient Name | Mrs. SABITA MUKHERJEE | Contact No | 8420210411 |
| Address | 42/1 SASHI BHUSAN GHOSH LANE | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||