Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13887 | Date 22/12/2025 |
| Token No | SM/25-26/3075 22/12/2025 | Serial | 013 |
| Patient Name | Mrs. SUCHISMITA SIKDAR | Contact No | 6289354768 |
| Address | 38 AKRABATI LANE | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||