Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02516 | Date 19/07/2019 |
| Token No | SM/25-26/2577 12/11/2025 | Serial | 004 |
| Patient Name | Mr. BIKASH PAL | Contact No | 9836304972 |
| Address | 84A PATUA PARA LANE | Age | 73 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||