Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09973 | Date 16/08/2023 |
| Token No | SM/22-23/11685 17/08/2023 | Serial | 005 |
| Patient Name | Mrs. SOMA DAS | Contact No | 8919437617 |
| Address | 39A S B GHOSH LANE | Age | 33 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||