Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10397 | Date 14/09/2023 |
| Token No | SM/22-23/12506 15/09/2023 | Serial | 001 |
| Patient Name | Mrs. MAMATA BISWAL | Contact No | 9330388521 |
| Address | 45 NANILAL STREET | Age | 36 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||