Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05122 | Date 29/11/2021 |
| Token No | SM/21-22/1534 29/11/2021 | Serial | 009 |
| Patient Name | Mrs. KABITA SINGHA | Contact No | 9874392876 |
| Address | 105 R B SARANI | Age | 74 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||