Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05481 | Date 28/02/2022 |
| Token No | SM/22-23/8262 13/03/2023 | Serial | 045 |
| Patient Name | Mrs. NITU DAS | Contact No | 9830706830 |
| Address | 120 POTUA PARA LANE | Age | 38 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||