Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01837 | Date 29/03/2019 |
| Token No | SM/18-19/2987 30/03/2019 | Serial | 005 |
| Patient Name | Mrs. BULBUL DEY | Contact No | 8240774585 |
| Address | 7 CHATTERJEE LANE | Age | 28 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||