Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12966 | Date 07/05/2025 |
| Token No | SM/25-26/517 21/05/2025 | Serial | 002 |
| Patient Name | Mr. LAXMAN SHA | Contact No | 9331445744 |
| Address | 33 N.L. BHATTACHARYA STREET | Age | 75 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||