Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13330 | Date 31/07/2025 |
| Token No | SM/25-26/2770 26/11/2025 | Serial | 010 |
| Patient Name | Mrs. SABJA DEBI | Contact No | 7603084136 |
| Address | 12 PITAMBAR DEY LANE | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||