Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 09134 | Date 22/05/2023 |
| Token No | SM/22-23/9786 23/05/2023 | Serial | 025 |
| Patient Name | Mr. ALO DEY | Contact No | 6291312467 |
| Address | 26/6 DEY BAGAN LANE | Age | 70 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||