Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13904 | Date 31/12/2025 |
| Token No | SM/25-26/3121 31/12/2025 | Serial | 001 |
| Patient Name | Mrs. SUPRIA KUNDU | Contact No | 9432500773 |
| Address | 35/1 AKC BHATTACHARJEE STREET | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||