Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02818 | Date 29/09/2022 |
| Token No | SM/22-23/5865 02/01/2023 | Serial | 046 |
| Patient Name | Mrs. KAKALI SHARMA | Contact No | 8100494822 |
| Address | GHORAMARA MALLICKPARA SERAMPORE 712203 | Age | 34 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||