Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05933 | Date 24/05/2022 |
| Token No | SM/22-23/3344 10/06/2022 | Serial | 022 |
| Patient Name | Mrs. RIYA DUTTA | Contact No | 8368993721 |
| Address | 537/D G.T ROAD | Age | 22 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||