Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 08211 | Date 31/01/2023 |
| Token No | SM/22-23/8353 16/03/2023 | Serial | 025 |
| Patient Name | Mrs. ANKITA PAL | Contact No | 9051166906 |
| Address | 11 J N LAHIRI ROAD | Age | 30 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||