Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04594 | Date 13/07/2021 |
| Token No | SM/25-26/145 17/04/2025 | Serial | 006 |
| Patient Name | Mrs. TILAKA DAS.,. | Contact No | 9163642743 |
| Address | 41 DR. NANILAL BHATTACHARJEE STREET | Age | 75 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||