Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04915 | Date 21/09/2021 |
| Token No | SM/22-23/5529 14/10/2022 | Serial | 039 |
| Patient Name | Mrs. SADHANA CHATTERJEE.. | Contact No | NOT GIVEN |
| Address | Age | 48 YRS Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||