Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 13777 | Date 25/11/2025 |
| Token No | SM/25-26/2777 26/11/2025 | Serial | 017 |
| Patient Name | Mrs. ANITA BHATTACHARJEE | Contact No | 6290550171 |
| Address | 2/A B.P. 1ST LANE | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||