Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04471 | Date 11/06/2021 |
| Token No | SM/22-23/15134 07/03/2024 | Serial | 021 |
| Patient Name | Mr. DEBASISH DEY | Contact No | 6290027689 |
| Address | 4 G.T. ROAD | Age | 66 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||