Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02445 | Date 09/07/2019 |
| Token No | SM/18-19/4749 11/07/2019 | Serial | 030 |
| Patient Name | Mr. TARAK GHOSH | Contact No | 8420982544 |
| Address | RAM SITA LANE | Age | 63 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||