Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12295 | Date 04/11/2024 |
| Token No | SM/25-26/3100 29/12/2025 | Serial | 006 |
| Patient Name | Mr. BISWANATH DEY | Contact No | 9339210925 |
| Address | 39 DOSTI LANE | Age | 72 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||