Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 12219 | Date 08/10/2024 |
| Token No | SM/24-25/19264 08/10/2024 | Serial | 003 |
| Patient Name | Mrs. MARIA DAS | Contact No | 9735781185 |
| Address | 18 NO J.GHAT LANE | Age | 24 Y Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||