Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12069 | Date 06/09/2024 |
| Token No | SM/24-25/18717 09/09/2024 | Serial | 050 |
| Patient Name | Mr. DILIP SHA | Contact No | 9097121288 |
| Address | 5/2C GOPAL GANGULY LANE | Age | 45 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||