Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08341 | Date 13/02/2023 |
| Token No | SM/22-23/8318 15/03/2023 | Serial | 019 |
| Patient Name | Mr. CHANDRAMANI SHAW | Contact No | 9330781332 |
| Address | 6/182 RAM SITA LANE | Age | 43 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||