Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13367 | Date 11/08/2025 |
| Token No | SM/25-26/1839 01/09/2025 | Serial | 039 |
| Patient Name | Mrs. K M JYOTI | Contact No | 8858154970 |
| Address | 31/B DR. N.L. BHATTACHARYA STREET | Age | 22 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||