Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 12557 | Date 22/01/2025 |
| Token No | SM/25-26/2767 26/11/2025 | Serial | 007 |
| Patient Name | Mr. BIPLAB ROY | Contact No | 9123945523 |
| Address | 85 R B SARANI | Age | 64 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||