Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00023 | Date 03/08/2018 |
| Token No | SM/18-19/3450 29/04/2019 | Serial | 024 |
| Patient Name | Mrs. SATYABATI PRADAHAN | Contact No | 9007258708 |
| Address | 45 N L BHATTACHARYA STREET | Age | 56 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||