Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02620 | Date 05/09/2022 |
| Token No | SM/22-23/2649 12/09/2022 | Serial | 002 |
| Patient Name | Mr. CHARANLAL MAHTO | Contact No | 7890214481 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 47 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||