Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02313 | Date 18/06/2019 |
| Token No | SM/18-19/4294 18/06/2019 | Serial | 013 |
| Patient Name | Mr. CHANDRANATH DEY | Contact No | 9831880838 |
| Address | 4 DEY STREET | Age | 64 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||