Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 10712 | Date 01/11/2023 |
| Token No | SM/22-23/13132 01/11/2023 | Serial | 019 |
| Patient Name | Mrs. ANITA DAS | Contact No | 9007087635 |
| Address | 11/88 BP 1ST LANE | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||