Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05804 | Date 06/05/2022 |
| Token No | SM/22-23/2904 06/05/2022 | Serial | 013 |
| Patient Name | Mrs. LAKKHI BANERJEE | Contact No | |
| Address | PATUA PARA | Age | 42 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||