Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02765 | Date 31/12/2018 |
| Token No | SM/18-19/10123 08/03/2019 | Serial | 014 Last Visit: 25/07/2025 |
| Patient Name | Mr. KARTIK PAL | Contact No | 9831575378 |
| Address | 13B/1 KUMAR PARA LANE CHATRA | Age | 52 Years,6 Months,22 Days Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||