Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 09491 | Date 24/06/2025 |
| Token No | SM/25-26/3896 24/06/2025 | Serial | 004 |
| Patient Name | Mr. KALIPADA DEY | Contact No | 9830714003 |
| Address | 3/168 MAHESH COLLNEY | Age | 47 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||