Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01167 | Date 04/09/2018 |
| Token No | SM/22-23/13052 16/10/2023 | Serial | 019 |
| Patient Name | Mr. SK SALAM | Contact No | 8820394467 |
| Address | 26 K C BHATTACHARYA STREET | Age | 63 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||