Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04129 | Date 01/03/2021 |
| Token No | SM/20-21/9111 01/03/2021 | Serial | 026 |
| Patient Name | Mrs. BARNALI BANERJEE | Contact No | 8478847547 |
| Address | 16 CHOWDHURY PARA LANE | Age | 45 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||