Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12957 | Date 05/05/2025 |
| Token No | SM/25-26/408 07/05/2025 | Serial | 030 |
| Patient Name | Mr. SUBRATA BISWAS | Contact No | 9674808302 |
| Address | 123/A T B STREET | Age | 48 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||