Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09972 | Date 16/08/2023 |
| Token No | SM/25-26/75 07/04/2025 | Serial | 019 |
| Patient Name | Mrs. HENA MONDAL | Contact No | 7449910543 |
| Address | 40/A SASHI BHUSAN GHOSH LANE | Age | 67 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||