Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 07505 | Date 03/11/2022 |
| Token No | SM/22-23/6002 03/11/2022 | Serial | 030 |
| Patient Name | Mrs. POONAM RAJBHAR | Contact No | 8584887354 |
| Address | 27 BAJAR BYE LANE | Age | 25 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||