Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04819 | Date 27/08/2021 |
| Token No | SM/22-23/5757 22/10/2022 | Serial | 009 |
| Patient Name | Mrs. JYOTI SHAW | Contact No | |
| Address | Age | 26 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||