Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04313 | Date 21/04/2021 |
| Token No | SM/25-26/2910 08/12/2025 | Serial | 005 |
| Patient Name | Mr. SAMAR KUMAR BHAR | Contact No | 9836935037 |
| Address | 71/A 1/2 PATUA PARA LANE | Age | 65 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||