Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 05329 | Date 20/01/2022 |
| Token No | SM/21-22/1976 21/01/2022 | Serial | 011 |
| Patient Name | Mrs. MALA KUNDU | Contact No | 9831197166 |
| Address | 329/B NITYA GOPAL DAS LANE | Age | 49 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||