Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05398 | Date 08/02/2022 |
| Token No | SM/21-22/2117 09/02/2022 | Serial | 006 |
| Patient Name | Mrs. PRIYANKA DEBI | Contact No | 8981131042 |
| Address | 14 AKHRA BATI LANE | Age | 26 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||