Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 09176 | Date 26/05/2023 |
| Token No | SM/22-23/9856 29/05/2023 | Serial | 003 |
| Patient Name | Mrs. RUPA DAS | Contact No | 8478968602 |
| Address | 55 AKHRA BATI LANE | Age | 40 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||