Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 07641 | Date 14/11/2022 |
| Token No | SM/22-23/6580 23/11/2022 | Serial | 028 |
| Patient Name | Mr. DURGA SHAW | Contact No | 9339349559 |
| Address | 49 K.M.SHA STREET | Age | 46 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||