Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05760 | Date 25/04/2022 |
| Token No | SM/22-23/2852 28/04/2022 | Serial | 015 |
| Patient Name | Mrs. DIPA BISWAS.. | Contact No | 9875686236 |
| Address | 8/A/2 NILMONI GHOSH LANE | Age | 21 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||