Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 06955 | Date 07/09/2022 |
| Token No | SM/25-26/2064 15/09/2025 | Serial | 021 |
| Patient Name | Mr. SANTI KUMAR MANNA | Contact No | NOT GIVEN |
| Address | 52/1 B/3 BHAGIRATHI LANE | Age | 77 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||