Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10627 | Date 03/10/2023 |
| Token No | SM/25-26/2219 09/10/2025 | Serial | 020 |
| Patient Name | Mrs. BASANTI MUKHERJEE | Contact No | 9874178213 |
| Address | 17A THAKURBATI STREET | Age | 64 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||