Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13763 | Date 22/11/2025 |
| Token No | SM/25-26/2726 24/11/2025 | Serial | 013 |
| Patient Name | Mrs. ARPITA LAHA | Contact No | 9064269497 |
| Address | 620 G.T. ROAD | Age | 42 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||