Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08698 | Date 05/04/2023 |
| Token No | SM/25-26/2989 13/12/2025 | Serial | 005 |
| Patient Name | Mr. SUKDEB JANA | Contact No | 8420853695 |
| Address | 9/496 COCKRAIN ROAD | Age | 72 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||