Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04065 | Date 12/10/2020 |
| Token No | SM/22-23/11541 10/08/2023 | Serial | 022 |
| Patient Name | Mrs. DIPA DEY | Contact No | 9432105495 |
| Address | DEY STREET | Age | 68 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||