Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08455 | Date 24/02/2023 |
| Token No | SM/22-23/8207 09/03/2023 | Serial | 002 |
| Patient Name | Mrs. MIRA DEBI | Contact No | 9007288230 |
| Address | RAM SITA LANE | Age | 35 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||