Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03026 | Date 12/09/2019 |
| Token No | SM/21-22/2315 03/03/2022 | Serial | 021 |
| Patient Name | Mrs. MITALI NATH | Contact No | 8185626832 |
| Address | 8A DOSTI LANE | Age | 41 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||