Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04359 | Date 21/06/2023 |
| Token No | SM/25-26/4987 19/07/2025 | Serial | 018 |
| Patient Name | Mrs. SURMILA KHATUN | Contact No | 8509039478 |
| Address | BHOLADANGA GAYESHPUR SANTIPUR NADIA | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||