Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10691 | Date 30/10/2023 |
| Token No | SM/22-23/13099 30/10/2023 | Serial | 015 |
| Patient Name | Miss TRISITA GHOSH | Contact No | 8910257317 |
| Address | 538/ B GT ROAD | Age | 15 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||