Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02436 | Date 08/07/2019 |
| Token No | SM/18-19/4754 11/07/2019 | Serial | 035 |
| Patient Name | Mrs. SHAMPA CHATTERJEE | Contact No | 7890916580 |
| Address | THAKUR BATI STREET | Age | 30 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||