Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04288 | Date 19/04/2021 |
| Token No | SM/25-26/725 09/06/2025 | Serial | 041 |
| Patient Name | Mr. SANDIP NATH | Contact No | 9330620840 |
| Address | 37 MADAM BAGAN | Age | 50 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||