Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10330 | Date 26/12/2025 |
| Token No | SM/25-26/12507 30/12/2025 | Serial | 010 |
| Patient Name | Mrs. MITA DAS | Contact No | 8420205994 |
| Address | UTTAR MONDAL PARA SIMLA MALLICKPARA SERAMPORE 712203 | Age | 46 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||