Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04380 | Date 13/05/2021 |
| Token No | SM/22-23/2765 20/04/2022 | Serial | 019 |
| Patient Name | Mr. RADHA RAMAN KOLAY | Contact No | 9830548529 |
| Address | 23A/1 PANCHANAN TALA LANE | Age | 61 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||