Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12938 | Date 28/04/2025 |
| Token No | SM/25-26/2955 11/12/2025 | Serial | 003 |
| Patient Name | Mrs. TRIPTI NANDI | Contact No | 8697462756 |
| Address | 5B/5 DEY STREET | Age | 68 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||