Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 09958 | Date 14/08/2023 |
| Token No | SM/22-23/11661 16/08/2023 | Serial | 034 |
| Patient Name | Mrs. SHAMPA SHARMA | Contact No | NOT GIVEN |
| Address | 86/1/G DEY STREET | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||