Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02059 | Date 14/05/2019 |
| Token No | SM/22-23/5355 27/09/2022 | Serial | 029 |
| Patient Name | Mrs. DIPALI SAHA | Contact No | 8420920103 |
| Address | BELTING BAZAR | Age | 54 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||