Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08559 | Date 15/03/2023 |
| Token No | SM/22-23/8348 16/03/2023 | Serial | 020 |
| Patient Name | Mr. PABITRA KUMAR SAHU | Contact No | 9143704404 |
| Address | 18/97 DR. N. L. BHATTACHARYA STREET | Age | 43 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||