Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05042 | Date 12/11/2021 |
| Token No | SM/21-22/1428 22/11/2021 | Serial | 001 |
| Patient Name | Mrs. RAASNA DAS | Contact No | 8013627559 |
| Address | 50/A PATUA PARA | Age | 28YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||