Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13139 | Date 19/06/2025 |
| Token No | SM/25-26/910 19/06/2025 | Serial | 017 |
| Patient Name | Mr. UTTAM SAMANTA | Contact No | NOT GIVEN |
| Address | NALIKUL | Age | 60 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||