Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 13855 | Date 11/12/2025 |
| Token No | SM/25-26/2969 11/12/2025 | Serial | 017 |
| Patient Name | Mrs. TANISHA DEVI | Contact No | 6291117621 |
| Address | 70/N KHATIR BAZAR LANE | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||