Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01994 | Date 29/04/2019 |
| Token No | SM/18-19/3488 30/04/2019 | Serial | 029 |
| Patient Name | Mrs. RITA DEBI | Contact No | 7003674325 |
| Address | 2 GOPAL GANGULY LANE | Age | 46 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||