Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 06850 | Date 31/08/2022 |
| Token No | SM/22-23/5173 16/09/2022 | Serial | 016 |
| Patient Name | Mrs. ISRABATI DEBI | Contact No | NOT GIVEN |
| Address | SERAMPORE THANA | Age | 65 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||