Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06364 | Date 18/07/2022 |
| Token No | SM/22-23/4568 16/08/2022 | Serial | 043 |
| Patient Name | Mrs. BASANTI DEY | Contact No | NOT GIVEN |
| Address | 30 DHULUPARA LANE | Age | 56 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||