Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05029 | Date 08/11/2021 |
| Token No | SM/22-23/7494 16/01/2023 | Serial | 006 |
| Patient Name | Mrs. SAMPURNA BANERJEE | Contact No | |
| Address | NALIKUL | Age | 53 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||