Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 09070 | Date 16/05/2023 |
| Token No | SM/25-26/2011 11/09/2025 | Serial | 006 |
| Patient Name | Mrs. DIPALI JANA | Contact No | 9674783522 |
| Address | 31I SHIBTALA LANE | Age | 44 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||