Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13866 | Date 13/12/2025 |
| Token No | SM/25-26/3018 17/12/2025 | Serial | 006 |
| Patient Name | Mrs. ALO SARKAR | Contact No | 9830590652 |
| Address | AKHRABATI LANE | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||