Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06116 | Date 16/06/2022 |
| Token No | SM/22-23/3567 23/06/2022 | Serial | 014 |
| Patient Name | Mrs. MONI NATH | Contact No | 8910781400 |
| Address | 33 G.T. ROAD | Age | 33 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||