Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 07408 | Date 26/10/2022 |
| Token No | SM/22-23/12998 10/10/2023 | Serial | 004 |
| Patient Name | Mrs. KUSUM ROY | Contact No | 9830154497 |
| Address | 22 BOSE PARA | Age | 58 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||