Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 10967 | Date 18/12/2023 |
| Token No | SM/22-23/13960 21/12/2023 | Serial | 005 |
| Patient Name | Mrs. REBA PAL | Contact No | 8017396344 |
| Address | 112 G.T. ROAD | Age | 36 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||