Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10687 | Date 30/10/2023 |
| Token No | SM/22-23/13095 30/10/2023 | Serial | 011 |
| Patient Name | Miss ANTARA DEY | Contact No | 9163076955 |
| Address | 3/30 MAHESH COLONY | Age | 12 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||