Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07959 | Date 16/12/2022 |
| Token No | SM/22-23/7075 20/12/2022 | Serial | 009 |
| Patient Name | Miss SUMANA DAS. | Contact No | 9007783030 |
| Address | 3/B DOCTOR BAGAN LANE | Age | 22 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||