Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02269 | Date 14/06/2019 |
| Token No | SM/24-25/15778 15/04/2024 | Serial | 059 |
| Patient Name | Mr. NIMAI PAL | Contact No | 9748231069 |
| Address | 9 NO LINE, INDIA JUTE MILL | Age | 52 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||