Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05145 | Date 10/12/2021 |
| Token No | SM/25-26/3024 17/12/2025 | Serial | 012 |
| Patient Name | Mr. SHYAMSUNDAR DUTTA | Contact No | 8335989944 |
| Address | KALITALA | Age | 42 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||