Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 14094 | Date 20/02/2026 |
| Token No | SM/25-26/5613 28/08/2026 | Serial | 003 |
| Patient Name | Mr. MUKTI SARKAR | Contact No | 8967560434 |
| Address | NEW TOWN | Age | 55 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||