Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02722 | Date 19/09/2022 |
| Token No | SM/22-23/2944 23/09/2022 | Serial | 008 |
| Patient Name | Mr. RAMBALI PASWAN | Contact No | 8777267367 |
| Address | 97/N/2 GURU GARDEN ROAD PRABASHNAGARSERAMPORE 712249 | Age | 55 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||