Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10960 | Date 14/12/2023 |
| Token No | SM/22-23/15561 01/04/2024 | Serial | 026 |
| Patient Name | Mr. SHIBAPRASAD DEY | Contact No | 8902263279 |
| Address | 1 DEY STREET | Age | 61 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||