Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07268 | Date 17/10/2022 |
| Token No | SM/22-23/9750 22/05/2023 | Serial | 028 |
| Patient Name | Mrs. KALPANA NATH. | Contact No | 9831374349 |
| Address | 12 BHAGIRATHI LANE | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||