Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04641 | Date 22/07/2021 |
| Token No | SM/22-23/5011 08/09/2022 | Serial | 030 |
| Patient Name | Mr. DIBYAJIT MALIK | Contact No | 9330423824 |
| Address | 9 A B GARDEN LANE | Age | 10 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||