Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05500 | Date 08/03/2022 |
| Token No | SM/21-22/2515 23/03/2022 | Serial | 013 |
| Patient Name | Mrs. SONA SAMANTARAY | Contact No | 8777571794 |
| Address | 44/B/5 DR.NANILAL BHATTACHARJEE STREET | Age | 23 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||