Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03709 | Date 03/02/2023 |
| Token No | SM/22-23/6532 03/02/2023 | Serial | 010 |
| Patient Name | Mrs. MADHABI RAY | Contact No | |
| Address | RAJYADHARPUR GOVT COLONY 712203 | Age | 65 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||