Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11677 | Date 19/06/2024 |
| Token No | SM/25-26/3044 18/12/2025 | Serial | 014 |
| Patient Name | Mrs. AMRITA DAS | Contact No | 9163063244 |
| Address | 10 NO RUDRARAM PANDIT LANE | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||