Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02400 | Date 02/07/2019 |
| Token No | SM/18-19/4675 08/07/2019 | Serial | 042 |
| Patient Name | Mrs. APARNA CHAKRABORTY | Contact No | 9830882913 |
| Address | 33/A PATUA PARA | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||