Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13276 | Date 23/07/2025 |
| Token No | SM/25-26/1379 24/07/2025 | Serial | 018 |
| Patient Name | Mrs. PARAMITA PAL | Contact No | 6290568973 |
| Address | 48D POTUAPARA LANE | Age | 48 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||