Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05221 | Date 04/01/2022 |
| Token No | SM/25-26/677 05/06/2025 | Serial | 017 |
| Patient Name | Mr. MALAY GHOSH | Contact No | 9874197044 |
| Address | 13 SASHI BHUSAN GHOSH LANE | Age | 54 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||