Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07922 | Date 09/12/2022 |
| Token No | SM/22-23/6928 12/12/2022 | Serial | 003 |
| Patient Name | Mrs. JHUMA BISWAS | Contact No | NOT GIVEN |
| Address | RISHRA | Age | 39 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||