Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13158 | Date 25/06/2025 |
| Token No | SM/25-26/1006 26/06/2025 | Serial | 026 |
| Patient Name | Mr. KRISHNA CHANDRA DEY | Contact No | 9123866398 |
| Address | 12/A/2 KASHI DAKTAR LANE | Age | 70 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||