Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05283 | Date 11/01/2022 |
| Token No | SM/25-26/201 23/04/2025 | Serial | 012 |
| Patient Name | Mrs. SOMA DUTTA | Contact No | 8478960060 |
| Address | 34b dey bagan lane | Age | 37 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||