Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 13877 | Date 18/12/2025 |
| Token No | SM/25-26/3036 18/12/2025 | Serial | 006 |
| Patient Name | Mrs. SAMIR GHOSH | Contact No | 9674998705 |
| Address | 72 KM SHA STREET | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||