Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13639 | Date 18/10/2025 |
| Token No | SM/25-26/2363 22/10/2025 | Serial | 004 |
| Patient Name | Mrs. NURJAHAN KHATOON | Contact No | 9051119215 |
| Address | MANIKTALA | Age | 62YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||