Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05704 | Date 19/04/2022 |
| Token No | SM/22-23/2766 20/04/2022 | Serial | 020 |
| Patient Name | Mr. BAIRAGI MALLICK | Contact No | 8334073862 |
| Address | DEY STREET | Age | 51 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||