Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 10026 | Date 18/08/2023 |
| Token No | SM/22-23/11742 18/08/2023 | Serial | 042 |
| Patient Name | Mrs. PRATIMA PARUI | Contact No | 9051483023 |
| Address | 18 KHASBAGAN LANE | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||