Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13607 | Date 13/10/2025 |
| Token No | SM/25-26/2321 16/10/2025 | Serial | 013 |
| Patient Name | Mrs. SIKHA RANI DEY | Contact No | 9432067979 |
| Address | 7 DEY STREET | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||