Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07243 | Date 14/10/2022 |
| Token No | SM/22-23/13059 17/10/2023 | Serial | 004 |
| Patient Name | Mr. MOLOY KUMAR PAL | Contact No | 8100648406 |
| Address | 5 RAM SITA LANE | Age | 71 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||