Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 14975 | Date 22/10/2026 |
| Token No | SM/25-26/6054 26/10/2026 | Serial | 004 |
| Patient Name | Mrs. CHAMPA DEBI | Contact No | 6291437154 |
| Address | 22 BANERJEE PARA | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||