Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 12893 | Date 21/04/2025 |
| Token No | SM/25-26/2133 20/09/2025 | Serial | 007 |
| Patient Name | Mr. CHANDRIKA PANDIT. | Contact No | 8334025508 |
| Address | 14 SATISH CHANDRA GHOSH LANE | Age | 63 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||