Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13387 | Date 14/08/2025 |
| Token No | SM/25-26/1688 14/08/2025 | Serial | 020 |
| Patient Name | Mrs. MOUTULI SADHUKHAN | Contact No | 7439115707 |
| Address | 52/A DHULIPARA LANE | Age | 22 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||