Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03981 | Date 06/07/2020 |
| Token No | SM/24-25/20919 12/02/2025 | Serial | 004 |
| Patient Name | Mr. DUDHKUMAR CHOWDHURY | Contact No | 9748926090 |
| Address | BARABELUR, KALTALA | Age | 58 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||