Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10077 | Date 16/10/2025 |
| Token No | SM/25-26/9305 17/10/2025 | Serial | 007 |
| Patient Name | Mrs. KALPANA DAS | Contact No | 7980027845 |
| Address | 1 NO SERAMPORE COLONY DAKSHIN RAJYADHARPUR 712203 | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||