Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07122 | Date 23/09/2022 |
| Token No | SM/22-23/11327 02/08/2023 | Serial | 030 |
| Patient Name | Mrs. MALABIKA DAS. | Contact No | 7439839704 |
| Address | 44/A DEY STREET | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||