Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10344 | Date 30/12/2025 |
| Token No | SM/25-26/12503 30/12/2025 | Serial | 006 |
| Patient Name | Mrs. MARJINA BIBI | Contact No | 7890884898 |
| Address | 61 A DHARMATALA LANE UTTARPARA | Age | 70 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||