Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13673 | Date 30/10/2025 |
| Token No | SM/25-26/2442 30/10/2025 | Serial | 011 |
| Patient Name | Mrs. RITA CHOWDHURI | Contact No | 9716412117 |
| Address | RAILAND ROAD | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||