Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13584 | Date 09/10/2025 |
| Token No | SM/25-26/2224 09/10/2025 | Serial | 025 |
| Patient Name | Mrs. KRISHNA MONDAL | Contact No | 8777456923 |
| Address | 39AB/1 SB GHOSH LANE | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||