Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04035 | Date 22/09/2020 |
| Token No | SM/22-23/10678 05/07/2023 | Serial | 053 |
| Patient Name | Mrs. PUJA DEBI | Contact No | NOT GIVEN |
| Address | RAM SITA LINE, INDIA JUTE MILL | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||