Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07949 | Date 15/12/2022 |
| Token No | SM/22-23/13164 02/11/2023 | Serial | 026 |
| Patient Name | Mrs. ALPANA SHIL | Contact No | NOT GIVEN |
| Address | 55 DHULIPARA BOTTALA | Age | 64 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||