Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07628 | Date 14/11/2022 |
| Token No | SM/22-23/6423 17/11/2022 | Serial | 001 |
| Patient Name | Mrs. UMA DAS. | Contact No | 8910659238 |
| Address | 35 S B GHOSH LANE | Age | 60 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||