Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10684 | Date 30/10/2023 |
| Token No | SM/22-23/13092 30/10/2023 | Serial | 008 |
| Patient Name | Mr. ANAND SHAW | Contact No | 8620025498 |
| Address | 60 BLC MILLS ROAD | Age | 22 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||