Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04426 | Date 01/06/2021 |
| Token No | SM/22-23/10309 17/06/2023 | Serial | 005 |
| Patient Name | Mrs. SANDHYA DAS | Contact No | NOT GIVEN |
| Address | 55 RAILAND ROAD | Age | 81 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||