Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10620 | Date 03/10/2023 |
| Token No | SM/22-23/12949 04/10/2023 | Serial | 028 |
| Patient Name | Miss ROHINI TANTI | Contact No | 9163777809 |
| Address | 132 DEY STREET PAL BAGAN | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||