Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13072 | Date 04/06/2025 |
| Token No | SM/25-26/679 05/06/2025 | Serial | 019 |
| Patient Name | Mr. SURESH PANDEY | Contact No | 8537051825 |
| Address | S.B. GHOSH LANE | Age | 75 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||