Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 13609 | Date 13/10/2025 |
| Token No | SM/25-26/2279 14/10/2025 | Serial | 002 |
| Patient Name | Mrs. BHAGYABATI BANIK | Contact No | 8100794959 |
| Address | SHIBTALA LANE | Age | 82 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||