Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13807 | Date 01/12/2025 |
| Token No | SM/25-26/2878 04/12/2025 | Serial | 013 |
| Patient Name | Mrs. GANGA BANIK | Contact No | 6290106565 |
| Address | 31 NILMONI GHOSH LANE | Age | 62 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||