Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08065 | Date 29/12/2022 |
| Token No | SM/22-23/7300 30/12/2022 | Serial | 030 |
| Patient Name | Mrs. GURIYA DEVI | Contact No | 9123903953 |
| Address | 10 DEY STREET | Age | 28 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||