Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12080 | Date 09/09/2024 |
| Token No | SM/25-26/2643 17/11/2025 | Serial | 007 |
| Patient Name | Mr. DILIP DAS | Contact No | 8336872585 |
| Address | 15 DEY BAGAN LANE DHULIPARA | Age | 55 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||