Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 12661 | Date 13/02/2025 |
| Token No | SM/25-26/5598 27/08/2026 | Serial | 004 |
| Patient Name | Mrs. KALPANA KARMAKAR.. | Contact No | 7685918571 |
| Address | 105 J.N. LAHIRI ROAD | Age | 67 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||