Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03825 | Date 18/02/2020 |
| Token No | SM/25-26/3034 18/12/2025 | Serial | 004 |
| Patient Name | Mrs. INA DEBI | Contact No | 9330611697 |
| Address | 59 LALIT MOHON BHATTACHARYA STREET | Age | 62 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||