Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13462 | Date 03/09/2025 |
| Token No | SM/25-26/1911 04/09/2025 | Serial | 021 |
| Patient Name | Mrs. NITU DAS. | Contact No | 9830706830 |
| Address | 120 POTUA PARA LANE | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||