Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06909 | Date 05/09/2022 |
| Token No | SM/22-23/4924 06/09/2022 | Serial | 039 |
| Patient Name | Mrs. LAKKHI DAS. | Contact No | NOT GIVEN |
| Address | PAL BAGAN | Age | 50 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||