Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13820 | Date 03/12/2025 |
| Token No | SM/25-26/2875 04/12/2025 | Serial | 010 |
| Patient Name | Mrs. JHULAN BISWAS | Contact No | 9674808302 |
| Address | 123/A THAKURBATI STREET | Age | 68 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||