Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06178 | Date 21/06/2022 |
| Token No | SM/24-25/19337 19/10/2024 | Serial | 005 |
| Patient Name | Mrs. MALATI PARAMANIK | Contact No | NOT GIVEN |
| Address | NALIKUL | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||