Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 08638 | Date 24/03/2023 |
| Token No | SM/22-23/10909 15/07/2023 | Serial | 008 |
| Patient Name | Mrs. DIPALI KOLEY | Contact No | 9874070535 |
| Address | 39A/2 S B GHOSH LANE | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||