Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 09702 | Date 20/07/2023 |
| Token No | SM/22-23/14292 17/01/2024 | Serial | 012 |
| Patient Name | Mrs. PRIYA DAS(HALDER) | Contact No | 8478819121 |
| Address | 36 N N COLONY | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||