Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02286 | Date 17/06/2019 |
| Token No | SM/18-19/4713 09/07/2019 | Serial | 029 |
| Patient Name | Mrs. SHARMILA DEY | Contact No | 8961111072 |
| Address | 5/C DEY ST | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||