Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 13008 | Date 20/05/2025 |
| Token No | SM/25-26/518 21/05/2025 | Serial | 003 |
| Patient Name | Mr. MD SAMIM | Contact No | 9330830490 |
| Address | K.M. BHATTACHARYA STREET | Age | 60 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||