Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09988 | Date 16/08/2023 |
| Token No | SM/22-23/11683 17/08/2023 | Serial | 003 |
| Patient Name | Mrs. GURIYA DEBI | Contact No | 7439021685 |
| Address | 10 DEY STREET | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||