Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05807 | Date 10/05/2022 |
| Token No | SM/22-23/2958 12/05/2022 | Serial | 015 |
| Patient Name | Mrs. PRATIMA GHOSH | Contact No | 8697424800 |
| Address | 32/A BHAGIRATHI LANE | Age | 44 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||