Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 01767 | Date 08/03/2019 |
| Token No | SM/18-19/2756 09/03/2019 | Serial | 005 |
| Patient Name | Miss MADHABI DUTTA.. | Contact No | 9163193107 |
| Address | 47 KALITALA | Age | 53 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||