Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13138 | Date 19/06/2025 |
| Token No | SM/25-26/922 21/06/2025 | Serial | 006 |
| Patient Name | Mr. SWARNENDU CHANDRA | Contact No | 7980607247 |
| Address | 17 POTUA PARA LANE | Age | 13 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||