Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10715 | Date 02/11/2023 |
| Token No | SM/22-23/13220 06/11/2023 | Serial | 043 |
| Patient Name | Miss TRIJITA GHOSH | Contact No | 8910257317 |
| Address | 538/B G T ROAD | Age | 15 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||