Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09459 | Date 22/06/2023 |
| Token No | SM/22-23/10622 04/07/2023 | Serial | 044 |
| Patient Name | Miss BANANI SIMLAI | Contact No | 9432120309 |
| Address | 35/A SASHI BHUSAN GHOSH | Age | 31 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||