Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09254 | Date 05/06/2023 |
| Token No | SM/22-23/10011 06/06/2023 | Serial | 005 |
| Patient Name | Mrs. RITA DEVI.. | Contact No | 7439625180 |
| Address | 1 LOLIT MOHAN BHATTACHARYA STREET | Age | 38 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||