Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12896 | Date 21/04/2025 |
| Token No | SM/25-26/435 12/05/2025 | Serial | 013 |
| Patient Name | Mrs. PUJA RAJBHAR | Contact No | 6290943890 |
| Address | KHURIGACHI NATUN PARA | Age | 22 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||