Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04273 | Date 07/04/2021 |
| Token No | SM/21-22/70 07/04/2021 | Serial | 022 |
| Patient Name | Mrs. CHANDRABATI MALLICK | Contact No | NOT GIVEN |
| Address | PITAMBAR DEY LANE | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||