Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 02122 | Date 27/05/2019 |
| Token No | SM/18-19/3877 30/05/2019 | Serial | 026 |
| Patient Name | Mrs. BABY NANDI | Contact No | 9903179441 |
| Address | 21 CHANDRAMOHAN ROY LANE | Age | 58 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||