Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08085 | Date 02/01/2023 |
| Token No | SM/22-23/7346 04/01/2023 | Serial | 009 |
| Patient Name | Mr. BAIRAGI MALLICK. | Contact No | 8334073862 |
| Address | 12 PITAMBAR DEY LANE | Age | 40 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||