Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05624 | Date 31/03/2022 |
| Token No | SM/21-22/2579 31/03/2022 | Serial | 034 |
| Patient Name | Mrs. PRONOTI CHAKRABORTY | Contact No | |
| Address | Age | 36 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||