Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07916 | Date 09/12/2022 |
| Token No | SM/22-23/7119 22/12/2022 | Serial | 013 |
| Patient Name | Mrs. MINATI DOLUI | Contact No | 7044008574 |
| Address | 6 DEY GHAT LANE | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||