Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09067 | Date 16/05/2023 |
| Token No | SM/22-23/9681 19/05/2023 | Serial | 003 |
| Patient Name | Mr. HARU DAS... | Contact No | NOT GIVEN |
| Address | MANIKTALA JALTANK | Age | 72 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||