Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05785 | Date 05/05/2022 |
| Token No | SM/25-26/1036 30/06/2025 | Serial | 021 |
| Patient Name | Mr. SK SABIR ALI | Contact No | 9433910672 |
| Address | 9 K C BHATTACHARJEE STREET | Age | 64 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||