Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05309 | Date 17/01/2022 |
| Token No | SM/21-22/1964 20/01/2022 | Serial | 018 |
| Patient Name | Mrs. LAXMI RAJBHAR | Contact No | 8100304772 |
| Address | 10 DEY STREET | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||