Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 09776 | Date 19/08/2025 |
| Token No | SM/25-26/6556 19/08/2025 | Serial | 015 |
| Patient Name | Mr. KARTICK POREL | Contact No | 9830092992 |
| Address | 40 DEY BAGAN LANE 712201 | Age | 59 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||