Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07656 | Date 14/11/2022 |
| Token No | SM/22-23/6306 14/11/2022 | Serial | 059 |
| Patient Name | Miss RAI SARKAR | Contact No | |
| Address | Age | 15 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||