Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 01978 | Date 25/04/2019 |
| Token No | SM/18-19/3454 29/04/2019 | Serial | 028 |
| Patient Name | Mrs. DOLLY BHATTACHARYA | Contact No | 9051612198 |
| Address | 82 THAKUR BATI ST | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||