Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 09560 | Date 06/07/2023 |
| Token No | SM/25-26/2423 29/10/2025 | Serial | 012 |
| Patient Name | Mrs. JAMUNA DUTTA | Contact No | 9883958424 |
| Address | 3/4 BROJO DUTTA LANE | Age | 66 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||