Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 11582 | Date 30/05/2024 |
| Token No | SM/24-25/16647 03/06/2024 | Serial | 034 |
| Patient Name | Mrs. SONALI DHAK | Contact No | |
| Address | 39C NILMONI GHOSH LANE | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||