Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09078 | Date 21/12/2020 |
| Token No | SM/20-21/28958 31/12/2020 | Serial | 040 Last Visit: 01/11/2025 |
| Patient Name | Mr. SHYAMACHARAN PANDIT | Contact No | 8479011877 |
| Address | 42 KUMOR PARA LANE SERAMPOPRE | Age | 58 Years,10 Months,0 Days Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||