Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10028 | Date 18/08/2023 |
| Token No | SM/22-23/11750 18/08/2023 | Serial | 050 |
| Patient Name | Mr. BIJAY KUMAR SHA | Contact No | 9830708557 |
| Address | 18/94 DR. NL BHATTACHARJEE STREET | Age | 32 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||