Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 10081 | Date 17/10/2025 |
| Token No | SM/25-26/9358 18/10/2025 | Serial | 004 |
| Patient Name | Mrs. SUMITA DAS DEY | Contact No | 6290448973 |
| Address | 37 J N ROAD SERAMPORE 712201 | Age | 16 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||