Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01540 | Date 03/01/2019 |
| Token No | SM/22-23/8910 17/04/2023 | Serial | 004 |
| Patient Name | Mr. TIRUPATI BISWAL | Contact No | 9836010315 |
| Address | 9 INDIA JUTE MILL | Age | 44 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||