Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02045 | Date 10/05/2019 |
| Token No | SM/18-19/3653 15/05/2019 | Serial | 005 |
| Patient Name | Mrs. RINA DEY | Contact No | 9432383398 |
| Address | 3/1 K.C BHATTACHARYA ST | Age | 70 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||