Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05318 | Date 18/01/2022 |
| Token No | SM/21-22/1961 20/01/2022 | Serial | 015 |
| Patient Name | Mrs. ANUSUYA CHANDA DAS | Contact No | 6294812990 |
| Address | 82 NEHERU NAGAR COLONY | Age | 29 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||