Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06093 | Date 14/06/2022 |
| Token No | SM/22-23/3437 16/06/2022 | Serial | 013 |
| Patient Name | Mrs. SANDHYA PANDIT | Contact No | NOT GIVEN |
| Address | J.N LAHIRI ROAD | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||