Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05297 | Date 13/01/2022 |
| Token No | SM/21-22/1917 17/01/2022 | Serial | 015 |
| Patient Name | Mrs. FARIDA BEGUM | Contact No | 9903624040 |
| Address | 7 K C BHATTACHARJEE STREET | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||