Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05226 | Date 05/01/2022 |
| Token No | SM/22-23/7015 15/12/2022 | Serial | 024 |
| Patient Name | Mrs. MITALI DEY | Contact No | 9674740210 |
| Address | 22 THAKUR BATI STREET | Age | 49 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||