Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04360 | Date 05/05/2021 |
| Token No | SM/25-26/950 25/06/2025 | Serial | 004 |
| Patient Name | Mr. PRADIP PODDAR | Contact No | 9836903085 |
| Address | 45 DEY STREET | Age | 52 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||