Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07621 | Date 12/11/2022 |
| Token No | SM/22-23/6237 12/11/2022 | Serial | 004 |
| Patient Name | Mrs. NITU KUMARI DEVI | Contact No | 7439960772 |
| Address | 7 HOSPITAL LANE | Age | 19 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||