Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06788 | Date 22/08/2022 |
| Token No | SM/22-23/4703 25/08/2022 | Serial | 014 |
| Patient Name | Mr. AKBAR KHAN | Contact No | NOT GIVEN |
| Address | MADANMOHAN TEMPLE, CHOWDHURY PARA | Age | 25 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||