Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 10140 | Date 05/11/2025 |
| Token No | SM/25-26/10645 19/11/2025 | Serial | 005 |
| Patient Name | Mrs. BITISHA DAS | Contact No | 7603048153 |
| Address | 50/1 3NO NATUNGRAM BAROHATKALITALA RISHRA MOREPUKUR 712250 | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | 90/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||