Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 08369 | Date 17/02/2023 |
| Token No | SM/22-23/10258 15/06/2023 | Serial | 045 |
| Patient Name | Mr. NIMAI MODOK | Contact No | NOT GIVEN |
| Address | PACHU BABUR BAZAR | Age | 75 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||