Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09998 | Date 22/09/2025 |
| Token No | SM/25-26/8387 22/09/2025 | Serial | 094 |
| Patient Name | Mrs. MOUPRIYA SAHA | Contact No | |
| Address | SERAMPORE | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||