Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13618 | Date 15/10/2025 |
| Token No | SM/25-26/2294 15/10/2025 | Serial | 005 |
| Patient Name | Mrs. ANJALI DEVI | Contact No | 9883601559 |
| Address | LALIT MOHON BHATTACHARYA STREET | Age | 22 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||