Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 11953 | Date 13/08/2024 |
| Token No | SM/24-25/18193 14/08/2024 | Serial | 028 |
| Patient Name | Mr. TAPAN GAIN | Contact No | 8013761203 |
| Address | 78A G.T. ROAD | Age | 48 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||