Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01842 | Date 29/03/2019 |
| Token No | SM/22-23/8746 05/04/2023 | Serial | 033 |
| Patient Name | Mrs. GOURI CHAKRABORTY | Contact No | |
| Address | Age | 30 Female | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||