Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 04722 | Date 05/08/2023 |
| Token No | SM/22-23/11394 05/08/2023 | Serial | 011 |
| Patient Name | Mrs. MITA ROY | Contact No | 7449931956 |
| Address | 147/A NEHERU NAGAR COLONY | Age | 38 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||