Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02268 | Date 14/06/2019 |
| Token No | SM/18-19/4242 17/06/2019 | Serial | 011 |
| Patient Name | Mrs. PARAMITA DAS NAG | Contact No | 7278649043 |
| Address | 57/A THAKUR BATI ST | Age | 25 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||