Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09253 | Date 05/06/2023 |
| Token No | SM/25-26/3067 22/12/2025 | Serial | 005 |
| Patient Name | Mrs. SURAIYA BEGUM | Contact No | 9433910672 |
| Address | 9 K C BHATTACHARJEE STREET | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||