Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13329 | Date 31/07/2025 |
| Token No | SM/25-26/1511 01/08/2025 | Serial | 005 |
| Patient Name | Mr. DEBOJIT SHEET | Contact No | 8017278346 |
| Address | 28/5 S B GHOSH LANE | Age | 7 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||