Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04622 | Date 16/07/2021 |
| Token No | SM/21-22/650 16/07/2021 | Serial | 007 |
| Patient Name | Mr. TAPAN SINGHA | Contact No | |
| Address | Age | 49 Male | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||