Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08184 | Date 30/01/2023 |
| Token No | SM/25-26/1765 28/08/2025 | Serial | 013 |
| Patient Name | Mrs. SHYAMALI BISWAS | Contact No | 9038518716 |
| Address | 4 KASHI DOCTOR LANE | Age | 67 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||