Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11940 | Date 12/08/2024 |
| Token No | SM/24-25/18192 14/08/2024 | Serial | 027 |
| Patient Name | Mr. JIBAN DEY | Contact No | 9163552914 |
| Address | 75 DEY STREET | Age | 72 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||