Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05330 | Date 20/01/2022 |
| Token No | SM/22-23/5546 15/10/2022 | Serial | 008 |
| Patient Name | Mr. AMIT RAM. | Contact No | 8961251810 |
| Address | 7 DEY GHAT LANE | Age | 26 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||