Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01037 | Date 04/10/2018 |
| Token No | SM/18-19/3085 04/04/2019 | Serial | 060 |
| Patient Name | Mrs. INDU DEBI | Contact No | 7044759374 |
| Address | 1 NO DEY GHAT LANE | Age | 37 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||