Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04390 | Date 13/05/2021 |
| Token No | SM/21-22/1108 08/09/2021 | Serial | 011 |
| Patient Name | Mrs. ARPITA KARMAKAR | Contact No | |
| Address | Age | 23 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||