Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10092 | Date 22/08/2023 |
| Token No | SM/22-23/11925 23/08/2023 | Serial | 047 |
| Patient Name | Mrs. RITA RAJBHAR | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 39 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||