Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12626 | Date 06/02/2025 |
| Token No | SM/25-26/2679 19/11/2025 | Serial | 004 |
| Patient Name | Mr. BARUN BAG | Contact No | 7003890126 |
| Address | 11 CHATTERJEE LANE | Age | 32 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||