Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 12345 | Date 14/11/2024 |
| Token No | SM/24-25/19725 14/11/2024 | Serial | 032 |
| Patient Name | Mrs. RENU DEBI | Contact No | 6290638460 |
| Address | NEW GATE CLUB | Age | 50 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||