Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09707 | Date 20/07/2023 |
| Token No | SM/22-23/11545 10/08/2023 | Serial | 026 |
| Patient Name | Mrs. DIPMALA DEBI | Contact No | 8420865985 |
| Address | RAM SITA LANE | Age | 38 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||