Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 12855 | Date 04/04/2025 |
| Token No | SM/25-26/1445 29/07/2025 | Serial | 001 |
| Patient Name | Mr. GURUPADA BAIRAGI | Contact No | 9903268518 |
| Address | 46A POTUA PARA | Age | 60 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||