Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 08012 | Date 23/12/2022 |
| Token No | SM/22-23/7168 27/12/2022 | Serial | 012 |
| Patient Name | Mrs. MANJU DEBI. | Contact No | 8340439789 |
| Address | 13 DEY STREET | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||