Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05306 | Date 17/01/2022 |
| Token No | SM/21-22/1931 18/01/2022 | Serial | 011 |
| Patient Name | Mrs. DIPTI DEY | Contact No | 8910465197 |
| Address | 32 THAKUR BATI | Age | 55 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||