Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07222 | Date 13/10/2022 |
| Token No | SM/22-23/6851 06/12/2022 | Serial | 028 |
| Patient Name | Mrs. MOUSUMI NATH | Contact No | 9836738651 |
| Address | 56 PANCHANANTALA LANE | Age | 30 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||