Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10795 | Date 22/11/2023 |
| Token No | SM/25-26/1498 31/07/2025 | Serial | 010 |
| Patient Name | Mrs. SHAMPA DEY | Contact No | 8981372223 |
| Address | 5B/5 DEY STREET | Age | 59 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||