Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 13645 | Date 21/10/2025 |
| Token No | SM/25-26/2368 22/10/2025 | Serial | 009 |
| Patient Name | Mrs. SHILPI DEY | Contact No | 9830532097 |
| Address | 12/3 JANNAGAR ROAD | Age | 42 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||