Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11687 | Date 22/06/2024 |
| Token No | SM/24-25/20051 04/12/2024 | Serial | 017 |
| Patient Name | Mrs. BARSHA JANA | Contact No | 9123745150 |
| Address | 5 DOSTI LANE | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||