Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 13273 | Date 23/07/2025 |
| Token No | SM/25-26/1439 28/07/2025 | Serial | 030 |
| Patient Name | Mr. SANAT SAMANTA | Contact No | 9038737456 |
| Address | 5/2 MONSHATALA LANE, MAHESH | Age | 46 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||