Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10783 | Date 16/11/2023 |
| Token No | SM/22-23/13744 13/12/2023 | Serial | 023 |
| Patient Name | Mr. RAMASANKAR SHAW | Contact No | 9339040488 |
| Address | 6/182 RAMSITA LANE | Age | 47 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||