Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 08021 | Date 27/12/2022 |
| Token No | SM/22-23/7171 27/12/2022 | Serial | 015 |
| Patient Name | Mrs. MONSA RAJBHAR | Contact No | NOT GIVEN |
| Address | 27 TIN BAZAR BYE LANE | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||