Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 04741 | Date 16/08/2021 |
| Token No | SM/21-22/2036 28/01/2022 | Serial | 020 |
| Patient Name | Mrs. PUSHPA BHOWMICK | Contact No | NOT GIVEN |
| Address | 85/A N N COLONY | Age | 71 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||