Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01331 | Date 04/12/2018 |
| Token No | SM/18-19/3592 10/05/2019 | Serial | 018 |
| Patient Name | Mrs. SAROJINI PRADHAN | Contact No | 8420775686 |
| Address | 9/498 INDIA JUTE MILL LINE | Age | 58 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||