Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03917 | Date 14/03/2020 |
| Token No | SM/22-23/2763 20/04/2022 | Serial | 017 |
| Patient Name | Mrs. USHA MALIK | Contact No | 8585812749 |
| Address | LALIT ABASAN, DEY STREET | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||