Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03874 | Date 05/03/2020 |
| Token No | SM/24-25/17608 18/07/2024 | Serial | 050 |
| Patient Name | Mr. BHIM SEN DAS | Contact No | 9883172955 |
| Address | 12 PITAMBAR DEY LANE | Age | 49 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||