Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07572 | Date 09/11/2022 |
| Token No | SM/22-23/6192 10/11/2022 | Serial | 036 |
| Patient Name | Mr. ANANTA DAS | Contact No | NOT GIVEN |
| Address | 3a pitambar dey lane | Age | 46 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||