Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 07539 | Date 07/11/2022 |
| Token No | SM/22-23/6181 10/11/2022 | Serial | 025 |
| Patient Name | Mrs. PALLABI ROY | Contact No | 8697613975 |
| Address | 55 RAILAND ROAD | Age | 18 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||