Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04866 | Date 01/09/2021 |
| Token No | SM/21-22/1049 01/09/2021 | Serial | 035 |
| Patient Name | Mr. PIRBHUBAN SINGH | Contact No | 8015287941 |
| Address | J N LAHIRI ROAD | Age | 63 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||