Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 06139 | Date 31/01/2024 |
| Token No | SM/22-23/17967 31/01/2024 | Serial | 008 |
| Patient Name | Mr. SHYAM PRASAD NAYAK | Contact No | 8478815078 |
| Address | 97/F/2 GURU GARDEN ROAD PROVASNAGAR SERAMPORE 712249 | Age | 62 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||