Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 08102 | Date 04/01/2023 |
| Token No | SM/22-23/7369 05/01/2023 | Serial | 004 |
| Patient Name | Mrs. CHAITALI PAL | Contact No | 6289248234 |
| Address | POTUA PARA, MANIKTALA | Age | 43 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||