Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08522 | Date 13/03/2023 |
| Token No | SM/22-23/8555 27/03/2023 | Serial | 002 |
| Patient Name | Mr. GOBINDO PRADHAN | Contact No | NOT GIVEN |
| Address | PITAMBAR DEY LANE | Age | 56 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||