Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05629 | Date 01/04/2022 |
| Token No | SM/22-23/2626 04/04/2022 | Serial | 032 |
| Patient Name | Mrs. BEDANA CHANDA | Contact No | 9433820805 |
| Address | 82 N N COLONY | Age | 59 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||