Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05464 | Date 22/02/2022 |
| Token No | SM/21-22/2270 24/02/2022 | Serial | 018 |
| Patient Name | Mrs. POLY KUNDU | Contact No | 8017396813 |
| Address | 379/A G T ROAD | Age | 59 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||