Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 04465 | Date 07/07/2023 |
| Token No | SM/22-23/12656 04/09/2023 | Serial | 006 |
| Patient Name | Mrs. SUNITA DAS | Contact No | 9163504473 |
| Address | BRANCH PANCHANANTALA ROAD KULIN PARA N 24 PRGS 700116 | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||