Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07738 | Date 21/11/2022 |
| Token No | SM/22-23/6684 28/11/2022 | Serial | 033 |
| Patient Name | Mr. BINAY KUMAR SHA | Contact No | 6205573670 |
| Address | 12/575 RAM SITA LANE | Age | 19 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||