Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07367 | Date 21/10/2022 |
| Token No | SM/22-23/5740 21/10/2022 | Serial | 040 |
| Patient Name | Miss SOURIMA CHAKRABORTY | Contact No | |
| Address | Age | 20 YRS Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||