Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09612 | Date 13/07/2023 |
| Token No | SM/22-23/10913 15/07/2023 | Serial | 012 |
| Patient Name | Mrs. SANTOSHI DIG | Contact No | 8697546828 |
| Address | 37 BHAGIRATHI LANE | Age | 32 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||