Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07829 | Date 28/11/2022 |
| Token No | SM/22-23/6688 29/11/2022 | Serial | 003 |
| Patient Name | Mrs. SONI DEVI KOIRI | Contact No | 7549814490 |
| Address | 79 DEY STREET | Age | 26 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||