Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10099 | Date 28/10/2025 |
| Token No | SM/25-26/9586 28/10/2025 | Serial | 003 |
| Patient Name | Mrs. SUNITA DEVI | Contact No | 7890184118 |
| Address | 129 GURU GARDEN ROAD SERAMPORE 712249 | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||