Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05445 | Date 18/02/2022 |
| Token No | SM/21-22/2219 21/02/2022 | Serial | 023 |
| Patient Name | Mrs. ANNAPURNA DUTTA | Contact No | 9732534709 |
| Address | NABAGRAM, GHOSAL PARA | Age | 50 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||