Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 12997 | Date 16/05/2025 |
| Token No | SM/25-26/507 19/05/2025 | Serial | 020 |
| Patient Name | Mr. PRABIR BANERJEE | Contact No | 8697123709 |
| Address | 164/B N N COLONY | Age | 56 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||