Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05337 | Date 21/01/2022 |
| Token No | SM/21-22/1990 24/01/2022 | Serial | 011 |
| Patient Name | Mrs. JYOTI KUMARI | Contact No | 9007696448 |
| Address | 14 J N LAHIRI ROAD | Age | 21 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||