Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13604 | Date 13/10/2025 |
| Token No | SM/25-26/2280 14/10/2025 | Serial | 003 |
| Patient Name | Mr. SK ASLAM | Contact No | 8961733517 |
| Address | 12 K.C. BHATTACHARYA STREET | Age | 45 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||