Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10663 | Date 11/10/2023 |
| Token No | SM/22-23/13006 11/10/2023 | Serial | 004 |
| Patient Name | Mr. SHIBU DAS | Contact No | 8017781930 |
| Address | 80 DEY STREET | Age | 45 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||