Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10661 | Date 05/10/2023 |
| Token No | SM/24-25/17903 05/08/2024 | Serial | 005 |
| Patient Name | Mrs. MANGALA DAS | Contact No | 9830477034 |
| Address | 28A/1 NKB STREET | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||