Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02384 | Date 01/07/2019 |
| Token No | SM/18-19/4632 05/07/2019 | Serial | 040 |
| Patient Name | Mr. SUDIP RAY. | Contact No | 8902271623 |
| Address | RAMSITA LANE | Age | 44 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||