Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11625 | Date 10/06/2024 |
| Token No | SM/25-26/2493 03/11/2025 | Serial | 029 |
| Patient Name | Mrs. SUPRIYA DEY | Contact No | 7044521830 |
| Address | 14 PANCHANAN TALA LANE | Age | 57 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||