Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04646 | Date 28/07/2023 |
| Token No | SM/22-23/11088 28/07/2023 | Serial | 020 |
| Patient Name | Mrs. PUJA DAS | Contact No | 6290225808 |
| Address | 85/B KUMIRJELA ROAD | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||