Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13672 | Date 30/10/2025 |
| Token No | SM/25-26/2499 03/11/2025 | Serial | 035 |
| Patient Name | Mr. BIYASH TIWARI. | Contact No | 9088461066 |
| Address | 2 BECHU DEY LANE | Age | 61 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||