Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12169 | Date 30/09/2024 |
| Token No | SM/24-25/19172 04/10/2024 | Serial | 007 |
| Patient Name | Mrs. ANITA POLAI | Contact No | 7980983991 |
| Address | 7/361 COCKRAIN ROAD | Age | 27 Y Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||