Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13721 | Date 12/11/2025 |
| Token No | SM/25-26/2576 12/11/2025 | Serial | 003 |
| Patient Name | Mrs. PRITI PAL SAHA | Contact No | 8274409981 |
| Address | 111 N.N. COLONY | Age | 30 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||