Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05499 | Date 08/03/2022 |
| Token No | SM/21-22/2419 14/03/2022 | Serial | 021 |
| Patient Name | Mrs. MOUSUMI DUTTA ROY | Contact No | 9051771489 |
| Address | 38 NEHERU NAGAR COLONY | Age | 31 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||