Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02604 | Date 02/09/2022 |
| Token No | SM/22-23/2414 02/09/2022 | Serial | 005 |
| Patient Name | Mrs. SANGITA KUMARI | Contact No | 9163891684 |
| Address | CHOTO BELU CHECK POST SERAMPORE 712203 | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||