Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 11651 | Date 13/06/2024 |
| Token No | SM/24-25/16880 13/06/2024 | Serial | 029 |
| Patient Name | Mrs. CHANDANI DAS(KUMARI) | Contact No | 8910472812 |
| Address | 122 RB SARANI | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||