Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12949 | Date 03/05/2025 |
| Token No | SM/25-26/401 07/05/2025 | Serial | 023 |
| Patient Name | Mr. UTTAM DEY | Contact No | 9474394291 |
| Address | DEY STREET | Age | 70 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||