Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 09279 | Date 14/05/2025 |
| Token No | SM/25-26/2059 15/05/2025 | Serial | 022 |
| Patient Name | Mrs. SOMA SIL | Contact No | 9088976116 |
| Address | 2/103 MAHESH COLONY SERAMPORE 712202 | Age | 46 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||