Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11450 | Date 25/04/2024 |
| Token No | SM/24-25/15986 25/04/2024 | Serial | 024 |
| Patient Name | Mrs. MAHUYA ADHIKARY | Contact No | 9051675284 |
| Address | 620 GT ROAD | Age | 44 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||