Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13424 | Date 28/08/2025 |
| Token No | SM/25-26/2837 01/12/2025 | Serial | 021 |
| Patient Name | Mrs. TULIKA DAS | Contact No | 7044438349 |
| Address | 48/ D KHAS BAGAN LANE | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||