Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09636 | Date 17/07/2023 |
| Token No | SM/22-23/12394 11/09/2023 | Serial | 012 |
| Patient Name | Mrs. CHANDANA SRIMANI | Contact No | 9883307315 |
| Address | NABAGRAM, GHOSAL PARA | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||