Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04090 | Date 10/11/2020 |
| Token No | SM/22-23/8209 09/03/2023 | Serial | 004 |
| Patient Name | Mrs. BANDANA DAS | Contact No | 9230124014 |
| Address | 26 DHULI PARA LANE | Age | 68 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||