Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01885 | Date 05/04/2019 |
| Token No | SM/18-19/3144 08/04/2019 | Serial | 025 |
| Patient Name | Mrs. JHILIK PAL | Contact No | 9748544783 |
| Address | 22 KAILASH CHATTERJEE LANE | Age | 27 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||