Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 13325 | Date 30/07/2025 |
| Token No | SM/25-26/1500 31/07/2025 | Serial | 012 |
| Patient Name | Mrs. GITA DEY | Contact No | 9681617070 |
| Address | BELTING BAZAR | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||