Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01946 | Date 17/06/2022 |
| Token No | SM/22-23/651 20/06/2022 | Serial | 003 |
| Patient Name | Mrs. PINKI DOM | Contact No | 7044718235 |
| Address | TENCHI GRAM PRABASHNAGAR SERAMPORE 712249 | Age | 29 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||