Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07568 | Date 09/11/2022 |
| Token No | SM/22-23/6182 10/11/2022 | Serial | 026 |
| Patient Name | Mrs. DIPA JAISWARA | Contact No | 7980627367 |
| Address | 7 DEY GHAT LANE | Age | 56 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||