Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11300 | Date 18/03/2024 |
| Token No | SM/24-25/20046 04/12/2024 | Serial | 012 |
| Patient Name | Mr. SUDIP KOIRI | Contact No | 9748284161 |
| Address | 36 PANCHANANTALA LANE | Age | 51 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||