Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06192 | Date 23/06/2022 |
| Token No | SM/22-23/3664 28/06/2022 | Serial | 041 |
| Patient Name | Mrs. SANTANA BANERJEE | Contact No | 9681527868 |
| Address | 7 CHATTERJEE LANE | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||