Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02170 | Date 04/06/2019 |
| Token No | SM/22-23/11876 22/08/2023 | Serial | 055 |
| Patient Name | Mr. NIRAJ RAM | Contact No | 7003674235 |
| Address | 2 GOPAL GANGULY LANE | Age | 19 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||