Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04407 | Date 19/05/2021 |
| Token No | SM/21-22/297 19/05/2021 | Serial | 019 |
| Patient Name | Mr. TUNTUN SINGH | Contact No | NOT GIVEN |
| Address | BANERJEE PARA | Age | 61 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||