Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06202 | Date 24/06/2022 |
| Token No | SM/22-23/9377 03/05/2023 | Serial | 040 |
| Patient Name | Mrs. TARA DEBI | Contact No | NOT GIVEN |
| Address | 39 L B S ROAD | Age | 40 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||