Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06239 | Date 28/06/2022 |
| Token No | SM/22-23/9550 15/05/2023 | Serial | 003 |
| Patient Name | Mr. HARU DAS | Contact No | 6291053875 |
| Address | 15 G.T. ROAD KALITALA | Age | 52 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||