Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 11200 | Date 28/02/2024 |
| Token No | SM/25-26/2183 08/10/2025 | Serial | 002 |
| Patient Name | Mrs. MOUSUMI KARMAKAR | Contact No | 9051711713 |
| Address | 56 DHULIPARA | Age | 46 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||