Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 00601 | Date 16/08/2018 |
| Token No | SM/18-19/4533 28/06/2019 | Serial | 023 |
| Patient Name | Mr. TARAK DEY | Contact No | 9163035703 |
| Address | 31 AKHRA BATI LANE | Age | 51 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||