Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12868 | Date 07/04/2025 |
| Token No | SM/25-26/70 07/04/2025 | Serial | 014 |
| Patient Name | Mrs. KAJAL DEBI | Contact No | 6289175369 |
| Address | PACHU BAZAR | Age | 19 Y Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||