Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07785 | Date 23/11/2022 |
| Token No | SM/22-23/8822 10/04/2023 | Serial | 046 |
| Patient Name | Mrs. PREMSHILA RAY | Contact No | 9007754737 |
| Address | 56 AKHRABATI LANE | Age | 36 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||