Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10280 | Date 09/12/2025 |
| Token No | SM/25-26/11706 09/12/2025 | Serial | 003 |
| Patient Name | Mrs. SUHANA KHATUN | Contact No | 7605013081 |
| Address | 89/C MALLICKPARA SERAMPORE 712203 | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||