Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00629 | Date 06/09/2018 |
| Token No | SM/24-25/20361 23/12/2024 | Serial | 029 |
| Patient Name | Mrs. SAMPA SAHA | Contact No | 8910863078 |
| Address | BANDEL | Age | 37 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||