Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02484 | Date 18/08/2022 |
| Token No | SM/22-23/9593 15/06/2023 | Serial | 006 |
| Patient Name | Mrs. DEBASHREE MONDAL | Contact No | 7003383084 |
| Address | 21/B G T ROAD GODAR BAGAN BYE LANE BAIDYABATI M 712204 | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||