Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02517 | Date 19/07/2019 |
| Token No | SM/25-26/933 23/06/2025 | Serial | 005 |
| Patient Name | Mrs. KRISHNA PAL.. | Contact No | 9836304972 |
| Address | 84A PATUA PARA LANE | Age | 64 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||