Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09725 | Date 21/07/2023 |
| Token No | SM/25-26/1442 28/07/2025 | Serial | 033 |
| Patient Name | Mr. PURBAYAN NANDI | Contact No | 9836954969 |
| Address | 4/A PITAMBAR DEY LANE | Age | 12 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||