Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 01610 | Date 20/05/2022 |
| Token No | SM/22-23/1804 02/08/2022 | Serial | 020 |
| Patient Name | Mr. SUMAN MAHATO | Contact No | 6200277071 |
| Address | SIMLA MALLICKPARA 712203 | Age | 39 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||