Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12993 | Date 15/05/2025 |
| Token No | SM/25-26/513 19/05/2025 | Serial | 026 |
| Patient Name | Mrs. SUNITI DEY | Contact No | 9331619339 |
| Address | 86/1/B DEY STREET | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||