Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10033 | Date 09/10/2025 |
| Token No | SM/25-26/8823 09/10/2025 | Serial | 007 |
| Patient Name | Mrs. MOLI MONDAL | Contact No | 7501232636 |
| Address | DUMURDAHA HOOGHLY | Age | 18 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||