Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04376 | Date 12/05/2021 |
| Token No | SM/21-22/2277 28/02/2022 | Serial | 002 |
| Patient Name | Mr. MAYA BHAR | Contact No | 7439778430 |
| Address | 71A 1/2 PATUA PARA LANE | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||