Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02404 | Date 02/07/2019 |
| Token No | SM/25-26/2575 12/11/2025 | Serial | 002 |
| Patient Name | Mrs. UMA HAZRA | Contact No | 7890661941 |
| Address | 2 BECHU DEY LANE | Age | 68 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||