Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04188 | Date 17/05/2023 |
| Token No | SM/22-23/8917 18/05/2023 | Serial | 002 |
| Patient Name | Mr. RAM SINGH | Contact No | 9073565411 |
| Address | 21 BORAL BAGAN LANE SERAMPORE M 712201 | Age | 27 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||