Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13530 | Date 18/09/2025 |
| Token No | SM/25-26/2085 18/09/2025 | Serial | 008 |
| Patient Name | Mrs. CHAITALI DAS | Contact No | 8637385840 |
| Address | PATUA PARA LANE | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||