Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12980 | Date 12/05/2025 |
| Token No | SM/25-26/433 12/05/2025 | Serial | 011 |
| Patient Name | Mrs. SHRESTHA DEY NANDI | Contact No | 7908574811 |
| Address | 47 A PANDIT KALINATH B STREET | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||