Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13790 | Date 27/11/2025 |
| Token No | SM/25-26/2798 27/11/2025 | Serial | 014 |
| Patient Name | Mrs. ASHA MALI | Contact No | 8420966721 |
| Address | 23B NATUN BAGAN LANE | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||