Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 10603 | Date 30/09/2023 |
| Token No | SM/22-23/12867 30/09/2023 | Serial | 002 |
| Patient Name | Mrs. KARABI DAS | Contact No | 8582880169 |
| Address | 459 GT ROAD | Age | 43 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||