Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 01107 | Date 28/09/2018 |
| Token No | SM/22-23/7126 22/12/2022 | Serial | 020 |
| Patient Name | Mrs. ARATI KUNDU | Contact No | |
| Address | 46 KHASBAGAN LANE | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||