Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09335 | Date 23/05/2025 |
| Token No | SM/25-26/2481 23/05/2025 | Serial | 012 |
| Patient Name | Mr. RAJSHAKHAR KOLEY | Contact No | 8945864817 |
| Address | DHATRIGRAM | Age | 28 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||