Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02341 | Date 24/06/2019 |
| Token No | SM/22-23/9616 17/05/2023 | Serial | 010 |
| Patient Name | Mrs. PUJA DAS | Contact No | 9123633195 |
| Address | 40 BHAGIRATHI LANE | Age | 36 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||