Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 08070 | Date 30/12/2022 |
| Token No | SM/25-26/2769 26/11/2025 | Serial | 009 |
| Patient Name | Mr. BAIDYANATH DAS. | Contact No | 8478921417 |
| Address | 12 R B SARANI ROAD | Age | 74 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||