Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12919 | Date 23/04/2025 |
| Token No | SM/25-26/1945 08/09/2025 | Serial | 017 |
| Patient Name | Mrs. SWAPNA DEY | Contact No | 9433402527 |
| Address | DEY STREET | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||