Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 04466 | Date 09/06/2021 |
| Token No | SM/21-22/395 10/06/2021 | Serial | 001 |
| Patient Name | Mrs. MALATI CHAKRABORTY | Contact No | NOT GIVEN |
| Address | KHATIR BAZAR | Age | 41 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||