Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07199 | Date 11/10/2022 |
| Token No | SM/22-23/5456 12/10/2022 | Serial | 025 |
| Patient Name | Miss LILA SHAW | Contact No | 9477162747 |
| Address | 83 DEY STREET | Age | 27 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||