Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02267 | Date 14/06/2019 |
| Token No | SM/18-19/4386 24/06/2019 | Serial | 016 |
| Patient Name | Mr. AMIT DAS | Contact No | 7278649043 |
| Address | 57/A THAKUR BATI ST | Age | 30 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||