Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11079 | Date 31/01/2024 |
| Token No | SM/22-23/14561 01/02/2024 | Serial | 033 |
| Patient Name | Mrs. RINA DEVI | Contact No | 7491864002 |
| Address | 1 NO GATE, INDIA JUTE MILL | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||