Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02645 | Date 07/09/2022 |
| Token No | SM/22-23/2588 08/09/2022 | Serial | 010 |
| Patient Name | Mr. GUPTESHWAR RAI | Contact No | 8100912966 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 59 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||