Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09786 | Date 21/08/2025 |
| Token No | SM/25-26/6903 26/08/2025 | Serial | 006 |
| Patient Name | Mrs. USHA KHATUN | Contact No | 6260371621 |
| Address | 91/E MALLICKPARA LANE SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||