Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10308 | Date 17/12/2025 |
| Token No | SM/25-26/12063 17/12/2025 | Serial | 010 |
| Patient Name | Mrs. TAHIRUN NISHA | Contact No | 9007683453 |
| Address | 88/E M D LANE SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||