Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05124 | Date 29/11/2021 |
| Token No | SM/21-22/1537 29/11/2021 | Serial | 012 |
| Patient Name | Mrs. BABITA DEBI | Contact No | 8336910850 |
| Address | KAILASH CHANDRA CHATTERJEE LANE | Age | 34 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||