Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05225 | Date 05/01/2022 |
| Token No | SM/22-23/12198 01/09/2023 | Serial | 034 |
| Patient Name | Mr. AJAY DEY | Contact No | 9674740210 |
| Address | 22 THAKUR BATI STREET | Age | 62 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||