Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11340 | Date 01/04/2024 |
| Token No | SM/25-26/2078 18/09/2025 | Serial | 001 |
| Patient Name | Mrs. RINTU DUTTA | Contact No | 7449443643 |
| Address | KASHI DOCTOR LANE | Age | 31 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||