Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 13878 | Date 18/12/2025 |
| Token No | SM/25-26/3063 22/12/2025 | Serial | 001 |
| Patient Name | Mr. NAYAN DAS | Contact No | 9088897873 |
| Address | K.M. SHA STREET | Age | 38 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||