Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10458 | Date 21/09/2023 |
| Token No | SM/22-23/12637 22/09/2023 | Serial | 036 |
| Patient Name | Mrs. NABANITA BAG | Contact No | 9874028056 |
| Address | 69 T B STREET | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||