Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02048 | Date 10/05/2019 |
| Token No | SM/18-19/3656 15/05/2019 | Serial | 008 |
| Patient Name | Miss PRITHI MUKHERJEE | Contact No | 9830705150 |
| Address | 12/A CHATTERJEE LANE | Age | 23 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||