Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09512 | Date 30/06/2025 |
| Token No | SM/25-26/4659 14/07/2025 | Serial | 019 |
| Patient Name | Mrs. SONALI ADHIKARI | Contact No | 6289495476 |
| Address | 9A/1 HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||