Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13327 | Date 30/07/2025 |
| Token No | SM/25-26/1479 30/07/2025 | Serial | 019 |
| Patient Name | Mrs. KARUNA CHAKRABORTY | Contact No | 6291489864 |
| Address | 18 DEY BAGAN | Age | 19 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||