Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01984 | Date 26/04/2019 |
| Token No | SM/24-25/16989 19/06/2024 | Serial | 043 |
| Patient Name | Mrs. RUPJHARI DEVI | Contact No | NOT GIVEN |
| Address | DEY ST | Age | 54 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||