Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03970 | Date 26/06/2020 |
| Token No | SM/25-26/6083 28/10/2026 | Serial | 003 |
| Patient Name | Mrs. ANITA GHOSH | Contact No | 9874764074 |
| Address | LALIT MOHAN BHATTACHARYA STREET | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||