Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01350 | Date 07/12/2018 |
| Token No | SM/22-23/15113 06/03/2024 | Serial | 055 |
| Patient Name | Mr. SONAI LOO | Contact No | 9038777439 |
| Address | 14/B DEY STREET | Age | 28 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||