Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04278 | Date 07/04/2021 |
| Token No | SM/22-23/3917 20/07/2022 | Serial | 001 |
| Patient Name | Mrs. REKHA DAS | Contact No | |
| Address | Age | 65 YRS Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||