Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02058 | Date 14/05/2019 |
| Token No | SM/18-19/3690 16/05/2019 | Serial | 030 |
| Patient Name | Mr. RANJIT NANDI | Contact No | 9830529691 |
| Address | J N LAHIRI ROAD | Age | 62 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||