Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12873 | Date 09/04/2025 |
| Token No | SM/25-26/96 09/04/2025 | Serial | 003 |
| Patient Name | Mrs. SANCHAITA KOLEY | Contact No | 6289951676 |
| Address | 100 A JOLCOL CHOWDHURY PARA | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||