Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02934 | Date 19/10/2022 |
| Token No | SM/22-23/4804 28/11/2022 | Serial | 019 |
| Patient Name | Mrs. RINA SARKAR | Contact No | 8420366561 |
| Address | 223/A/104 SADAGOP PARA LANE BIBEKANANDA SARANI BAIDYABATI M 712203 | Age | 54 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||