Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 08186 | Date 31/01/2023 |
| Token No | SM/22-23/7829 10/02/2023 | Serial | 025 |
| Patient Name | Mrs. NISHA DEBI | Contact No | NOT GIVEN |
| Address | NEAR TELEPHONE EXCHANGE | Age | 30 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||