Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07401 | Date 09/07/2024 |
| Token No | SM/24-25/24700 09/07/2024 | Serial | 016 |
| Patient Name | Mr. DEBOTTAM DAS | Contact No | 8458091240 |
| Address | 3/68/D DEVI VILA ANIS MOHAN SARANI FD ROAD MALLIKPARA 712203 | Age | 27 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||