Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00511 | Date 20/08/2018 |
| Token No | SM/22-23/5605 17/10/2022 | Serial | 059 |
| Patient Name | Mr. SANJOY DAS | Contact No | |
| Address | Age | 23 Male | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||