Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08226 | Date 02/02/2023 |
| Token No | SM/22-23/10203 14/06/2023 | Serial | 025 |
| Patient Name | Mrs. JAYATI DAS | Contact No | 9123032374 |
| Address | 40 DOSTI LANE | Age | 43 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||