Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10106 | Date 23/08/2023 |
| Token No | SM/22-23/11940 24/08/2023 | Serial | 007 |
| Patient Name | Mrs. DALIA NANDI | Contact No | 9123865353 |
| Address | 5/A L.M.B. STREET | Age | 31 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||