Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04201 | Date 25/03/2021 |
| Token No | SM/22-23/8686 31/03/2023 | Serial | 036 |
| Patient Name | Mr. BRAJALAL DAS | Contact No | 9874521048 |
| Address | 20 R.B. SARANI | Age | 52 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||