Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09520 | Date 30/06/2025 |
| Token No | SM/25-26/6545 19/08/2025 | Serial | 004 |
| Patient Name | Mrs. RUPSONA KHATUN | Contact No | 6291193492 |
| Address | 89/A MALLICKPARA LANE SERAMPORE 712203 | Age | 31 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||