Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03710 | Date 07/01/2020 |
| Token No | SM/22-23/8253 13/03/2023 | Serial | 036 |
| Patient Name | Mr. DILIP KUMAR SHAW | Contact No | 9874440016 |
| Address | 14 ACHARYA K C BHATTACHARYE STREET | Age | 34 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||