Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00539 | Date 31/08/2018 |
| Token No | SM/22-23/14768 12/02/2024 | Serial | 044 |
| Patient Name | Mrs. PUTUL DAS | Contact No | |
| Address | Age | 55 YRS Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||