Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 13858 | Date 11/12/2025 |
| Token No | SM/25-26/2975 12/12/2025 | Serial | 001 |
| Patient Name | Mr. AMIT KUMAR SHAW | Contact No | 9123634599 |
| Address | 8 SHIBTALA LANE | Age | 27 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||