Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10207 | Date 22/11/2025 |
| Token No | SM/25-26/10969 24/11/2025 | Serial | 070 |
| Patient Name | Miss SOMA DAS | Contact No | 8017329341 |
| Address | GHORAMARA P SERAMPORE 712203 | Age | 36 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||