Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07580 | Date 10/11/2022 |
| Token No | SM/22-23/6238 12/11/2022 | Serial | 005 |
| Patient Name | Mrs. TIYA DAS | Contact No | 9903038514 |
| Address | 5 AKHRA BATI LANE | Age | 27 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||