Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08132 | Date 06/01/2023 |
| Token No | SM/22-23/8879 11/04/2023 | Serial | 045 |
| Patient Name | Mr. NEWA DEBI | Contact No | 7980013630 |
| Address | 9/C1 DEY STREET | Age | 44 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||