Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06687 | Date 10/08/2022 |
| Token No | SM/22-23/4565 16/08/2022 | Serial | 040 |
| Patient Name | Mrs. SANDITA RAKSHIT | Contact No | 7595858430 |
| Address | 49 POTUA PARA LANE | Age | 59 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||