Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 10705 | Date 22/02/2022 |
| Token No | SM/21-22/10178 23/02/2022 | Serial | 029 Last Visit: 25/05/2022 |
| Patient Name | Mr. SANJAY NAYEK | Contact No | |
| Address | 17/A TULSICHARAN GOSWAMI STREET | Age | 44 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||