Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07877 | Date 02/12/2022 |
| Token No | SM/22-23/8288 14/03/2023 | Serial | 024 |
| Patient Name | Mrs. KALPANA BHOWMICK | Contact No | 9830346313 |
| Address | 62 DHULIPARA LANE | Age | 34 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||