Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13647 | Date 22/10/2025 |
| Token No | SM/25-26/2422 29/10/2025 | Serial | 011 |
| Patient Name | Mr. AMIT DAS | Contact No | 8582933254 |
| Address | 118 G.T. ROAD MANIKTALA | Age | 50 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||