Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04139 | Date 05/03/2021 |
| Token No | SM/25-26/2225 09/10/2025 | Serial | 026 |
| Patient Name | Mrs. SNIGDHA BANERJEE | Contact No | 9477997572 |
| Address | 66, THAKUR BATI STREET | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||