Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01962 | Date 23/04/2019 |
| Token No | SM/18-19/3518 02/05/2019 | Serial | 027 |
| Patient Name | Mrs. TANUSREE ROY | Contact No | 7044008574 |
| Address | 6 DEY GHAT LANE | Age | 30 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||