Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09696 | Date 20/07/2023 |
| Token No | SM/22-23/14759 12/02/2024 | Serial | 035 |
| Patient Name | Mrs. BISAKHA DIG | Contact No | 9477334270 |
| Address | 42 BHAGIRATHI LANE | Age | 63 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||