Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04640 | Date 22/07/2021 |
| Token No | SM/25-26/1153 10/07/2025 | Serial | 017 |
| Patient Name | Mr. AVIJIT MALIK | Contact No | 7439087253 |
| Address | 9 A B GARDEN LANE | Age | 17 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||