Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13279 | Date 23/07/2025 |
| Token No | SM/25-26/1367 24/07/2025 | Serial | 006 |
| Patient Name | Mr. SHIBSHANKAR DEY. | Contact No | 7890955253 |
| Address | DEY STREET | Age | 32 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||