Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 10222 | Date 25/11/2025 |
| Token No | SM/25-26/10985 25/11/2025 | Serial | 014 |
| Patient Name | Mr. BINOD KUMAR SINGH | Contact No | 7980592473 |
| Address | 6/5 BAISHNAB PARA 712202 | Age | 50 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||