Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05890 | Date 23/05/2022 |
| Token No | SM/22-23/6654 28/11/2022 | Serial | 003 |
| Patient Name | Mrs. BHANU SADHUKHAN | Contact No | 9674360083 |
| Address | 86/1/H DEY STREET | Age | 48 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||