Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13610 | Date 13/10/2025 |
| Token No | SM/25-26/2281 14/10/2025 | Serial | 004 |
| Patient Name | Mr. AMAN SHAW | Contact No | 9748066905 |
| Address | MANIKTALA DEY BAGAN | Age | 23 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||