Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04651 | Date 23/07/2021 |
| Token No | SM/22-23/5998 03/11/2022 | Serial | 026 |
| Patient Name | Mrs. ASHA DEBI... | Contact No | 8013280906 |
| Address | RAM SITA LINE | Age | 41 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||