Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05524 | Date 11/03/2022 |
| Token No | SM/21-22/2454 16/03/2022 | Serial | 019 |
| Patient Name | Mrs. SHILA CHAKRABORTY | Contact No | NOT GIVEN |
| Address | BHAGIRATHI LANE | Age | 71 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||