Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11985 | Date 21/08/2024 |
| Token No | SM/24-25/20842 05/02/2025 | Serial | 014 |
| Patient Name | Mr. GOPAL BAG | Contact No | 9051638125 |
| Address | 3 PITAMBAR DEY LANE | Age | 55 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||