Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06415 | Date 20/07/2022 |
| Token No | SM/25-26/2697 21/11/2025 | Serial | 001 |
| Patient Name | Mr. SUBRATA CHATTOPADHYAY | Contact No | NOT GIVEN |
| Address | NALIKUL | Age | 61 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||