Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 08669 | Date 30/03/2023 |
| Token No | SM/22-23/8681 31/03/2023 | Serial | 031 |
| Patient Name | Mrs. MINA DEBI | Contact No | 9007133556 |
| Address | 20 BOSEPARA LANE | Age | 23 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||