Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 04194 | Date 25/03/2021 |
| Token No | SM/21-22/2001 25/01/2022 | Serial | 010 |
| Patient Name | Mrs. BANALATA PAL | Contact No | 6290325395 |
| Address | 10/A NILMANI GHOSH LANE | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||