Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05630 | Date 01/04/2022 |
| Token No | SM/22-23/2630 04/04/2022 | Serial | 036 |
| Patient Name | Mrs. BANDANA SAHA | Contact No | 9123048032 |
| Address | 18 N N COLONY | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||