Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01940 | Date 18/04/2019 |
| Token No | SM/22-23/14611 05/02/2024 | Serial | 040 |
| Patient Name | Mrs. NISHA DAS | Contact No | |
| Address | Age | 24 YRS Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||