Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 14810 | Date 27/08/2026 |
| Token No | SM/25-26/5605 27/08/2026 | Serial | 011 |
| Patient Name | Mrs. SURAVI BISWAS | Contact No | 7569857595 |
| Address | 45 DR. NLB STREET | Age | 22 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||