Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 12996 | Date 15/05/2025 |
| Token No | SM/25-26/464 15/05/2025 | Serial | 015 |
| Patient Name | Mrs. SWARNAMOYEE CHAKRABORTY | Contact No | |
| Address | NALIKUL | Age | 68 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||