Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02468 | Date 11/07/2019 |
| Token No | SM/18-19/4821 16/07/2019 | Serial | 037 |
| Patient Name | Mrs. RUMA ROY | Contact No | 8902271623 |
| Address | 11/B RAM SITA LANE | Age | 74 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||