Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05361 | Date 28/01/2022 |
| Token No | SM/21-22/2070 01/02/2022 | Serial | 019 |
| Patient Name | Mr. SEEMIT DAS | Contact No | 8637359721 |
| Address | N N COLONY | Age | 29 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||