Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03379 | Date 14/11/2019 |
| Token No | SM/25-26/2628 14/11/2025 | Serial | 005 |
| Patient Name | Master ABHIJIT MALIK | Contact No | 9674470364 |
| Address | 9 ANNADA BABU GARDEN LANE | Age | 12 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||