Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05156 | Date 14/12/2021 |
| Token No | SM/21-22/1634 14/12/2021 | Serial | 025 |
| Patient Name | Mr. NARAYAN CH SARKAR | Contact No | NOT GIVEN |
| Address | 10 MAHESH COLONY | Age | 75 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||